DR. MIRA GHALY DMD MSC NPI 1144671397

NPI Information

NPI: 1144671397
Provider Name: DR. MIRA GHALY, DMD, MSC
Classification: Dentist - 1223P0300X
Entity Type: Individual

Specialization: Periodontics

PECOS Registration: Yes

Address:
1430 JOHN WESLEY GILBERT DR
AUGUSTA, GA
ZIP 30912
Phone: (706) 721-2442
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DR. Mira Ghaly, DMD, MSC is a periodontics dentist in Augusta, GA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. DR. Mira Ghaly, DMD, MSC NPI is 1144671397. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1430 JOHN WESLEY GILBERT DR
AUGUSTA, GA
ZIP 30912-001
Phone: (706) 721-2442

The NPI 1144671397 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 6/29/2016 and was last updated on 4/13/2023.

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	1223P0300X	Dentist	Periodontics	DNCS000514	GEORGIA	No
2	1223P0300X	Dentist	Periodontics	DN015842	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	00321649A	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: 4/28/2024

NPI Synchronization or Removal

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