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EAGLIN DENTAL GROUP JOHNS CREEK NPI 1245507292


NPI Information

NPI: 1245507292
Provider Name: EAGLIN DENTAL GROUP, JOHNS CREEK
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
6290 ABBOTTS BRIDGE RD STE 101
JOHNS CREEK, GA
ZIP 30097
Phone: (770) 418-1777
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EAGLIN DENTAL GROUP, JOHNS CREEK is a general practice dentist in Johns Creek, 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. EAGLIN DENTAL GROUP, JOHNS CREEK NPI is 1245507292. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

6290 ABBOTTS BRIDGE RD STE 101
JOHNS CREEK, GA
ZIP 30097-750
Phone: (770) 418-1777
Fax: (678) 646-5982

The provider's authorized official is Jason S Eaglin .
The authorized official title is Owner and has the following contact phone number (770) 418-1777.

The enumeration date for this NPI number is 11/18/2011 and was last updated on 11/18/2011.


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
11223P0221XDentistPediatric DentistryDN013169GEORGIANo
21223G0001XDentistGeneral PracticeDN013169GEORGIAYes

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
1777472578DMEDICAIDGEORGIA

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

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