GA OMS SDS PC NPI 1548146426

NPI Information

  • NPI: 1548146426
  • Provider Name: GA OMS SDS PC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 1380 PEACHTREE INDUSTRIAL BLVD STE 100
    SUWANEE, GA
    ZIP 30024
  • Phone: (770) 232-1191

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NPI Details

GA OMS SDS PC is an oral and maxillofacial surgery dentist in Suwanee, GA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. GA OMS SDS PC NPI is 1548146426. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1380 PEACHTREE INDUSTRIAL BLVD STE 100
SUWANEE, GA
ZIP 30024-793
Phone: (770) 232-1191

The provider's authorized official is Charlotte Dasch .
The authorized official title is Sr. Director Of Credentialing and has the following contact phone number (504) 638-0303.

The enumeration date for this NPI number is 8/14/2025 and was last updated on 8/14/2025.

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
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 11/21/2025

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