ENW DENTISTRY PC DBA NPI 1134223696

NPI Information

NPI: 1134223696
Provider Name: ENW DENTISTRY PC DBA

Doing Business As: ZOOM DENTAL

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
207 SW UPPER RIVERDALE ROAD
RIVERDALE, GA
ZIP 30274
Phone: (770) 751-8887
Get Directions

ENW DENTISTRY PC DBA is a general practice dentist in Riverdale, GA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. ENW DENTISTRY PC DBA NPI is 1134223696. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Zoom Dental.

The provider's business location address is:

207 SW UPPER RIVERDALE ROAD
RIVERDALE, GA
ZIP 30274-537
Phone: (770) 751-8887

The provider's authorized official is Eugene N Witkin .
The authorized official title is Dds/owner and has the following contact phone number (770) 751-8887.

The enumeration date for this NPI number is 9/12/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	009491	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00969724E	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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