ADVANCED DENTAL ARTS LLC NPI 1679969380

NPI Information

  • NPI: 1679969380
  • Provider Name: ADVANCED DENTAL ARTS, LLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 4705 NORTHSIDE DR
    SUITE 100
    MACON, GA
    ZIP 31210
  • Phone: (478) 207-6939

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NPI Details

ADVANCED DENTAL ARTS, LLC is a dental clinic center in Macon, GA. ADVANCED DENTAL ARTS, LLC NPI is 1679969380. The provider is registered as an organization entity type.

The provider's business location address is:

4705 NORTHSIDE DR
SUITE 100
MACON, GA
ZIP 31210-698
Phone: (478) 207-6939
Fax: (478) 254-9638

The provider's authorized official is Samer Mufid Othman .
The authorized official title is Owner and has the following contact phone number (478) 207-6939.

The enumeration date for this NPI number is 4/9/2015 and was last updated on 4/9/2015.

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
1261QD0000XClinic/CenterDentalDN014686GEORGIAYes

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: 11/21/2025

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