Active NPI
Jenai Bostic
- Dentist
- Douglasville, GA
National Provider Identifier
1982394631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN123151
- Practice address
- 9579 Ga-5 Suite 701
Douglasville, GA 30135-3356 - Phone
- (770) 746-8683
- NPI assigned
- May 8, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN123151 | GA | Primary |
Addresses
Primary practice location
9579 Ga-5 Suite 701
Douglasville, GA 30135-3356
Mailing address
1919 7TH Ave S
Birmingham, AL 35233-2005
Phone (205) 934-3387
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN123151 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Douglasville Dental Associates, P.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Douglasville, GA
- NPI 1639353964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750377600000",
"number": "1982394631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1919 7TH AVE S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352332005",
"telephone_number": "205-934-3387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9579 GA-5 SUITE 701",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301353356",
"telephone_number": "770-746-8683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSTIC",
"first_name": "JENAI",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-08",
"last_updated": "2025-06-20",
"certification_date": "2025-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN123151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.