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AUGUSTA DENTAL ASSOCIATES LLC NPI 1619901808


NPI Information

NPI: 1619901808
Provider Name: AUGUSTA DENTAL ASSOCIATES, LLC

Former Legal Business Name: MICHAEL O. VERNON, DMD, PC

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1218 AUGUSTA WEST PARKWAY
AUGUSTA, GA
ZIP 30909
Phone: (706) 860-0518
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AUGUSTA DENTAL ASSOCIATES, LLC is a general practice dentist in Augusta, 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. AUGUSTA DENTAL ASSOCIATES, LLC NPI is 1619901808. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Michael O. Vernon, Dmd, Pc.

The provider's business location address is:

1218 AUGUSTA WEST PARKWAY
AUGUSTA, GA
ZIP 30909-808
Phone: (706) 860-0518
Fax: (706) 860-4902

The provider's authorized official is Christopher Michael Moldovan .
The authorized official title is Owner/dentist and has the following contact phone number (706) 860-0518.

The enumeration date for this NPI number is 7/11/2006 and was last updated on 7/14/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice8815GEORGIANo
21223G0001XDentistGeneral Practice012377GEORGIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100922655AMEDICAIDGEORGIA
200137948BMEDICAIDGEORGIA

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

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