Provider Type Icon

CREEKSIDE ORAL SURGERY INC NPI 1992586143


NPI Information

NPI: 1992586143
Provider Name: CREEKSIDE ORAL SURGERY INC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
10700 MEDLOCK BRIDGE RD STE 204
JOHNS CREEK, GA
ZIP 30097
Phone: (770) 764-0840
Get Directions

CREEKSIDE ORAL SURGERY INC is an oral and maxillofacial surgery dentist in Johns Creek, 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. CREEKSIDE ORAL SURGERY INC NPI is 1992586143. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10700 MEDLOCK BRIDGE RD STE 204
JOHNS CREEK, GA
ZIP 30097-455
Phone: (770) 764-0840

The provider's authorized official is Nkemakonam Egolum .
The authorized official title is Owner and has the following contact phone number (770) 764-0840.

The enumeration date for this NPI number is 10/12/2023 and was last updated on 10/12/2023.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.