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GINA W ROBERTS NPI 1962675397


NPI Information

NPI: 1962675397
Provider Name: GINA W ROBERTS
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
146 S TALLAHASSEE ST
HAZLEHURST, GA
ZIP 31539
Phone: (912) 375-4531
Get Directions

GINA W ROBERTS is a general practice dentist in Hazlehurst, 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. GINA W ROBERTS NPI is 1962675397. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

146 S TALLAHASSEE ST
HAZLEHURST, GA
ZIP 31539-457
Phone: (912) 375-4531
Fax: (912) 375-4532

The provider's authorized official is Gina W Roberts .
The authorized official title is Owner and has the following contact phone number (912) 375-4531.

The enumeration date for this NPI number is 4/7/2008 and was last updated on 4/7/2008.


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
11223G0001XDentistGeneral Practice10748GEORGIAYes

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
100386636BMEDICAIDGEORGIA
21861601882OTHERINDIVIDUAL NPI

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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