Unknown Individual – General Practice Dentistry, NPI 1003856485

Unknown Individual is a healthcare provider. based in Marietta, Georgia. specializing in General Practice Dentistry. They hold a License No. 10627 (GA). The NPI Number for Unknown Individual is 1003856485

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1003856485
Phone
(770) 509-8026
Address
4302 HIGHBORNE DR NE
Deactivation Date
1 June 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 4302 HIGHBORNE DR NE

    MARIETTA, GA 300662429

    Phone: (770) 509-8026

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30066)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1003856485 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to General Practice Dentistry. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Marietta?
Public fields place Unknown Individual around Marietta, Georgia. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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