Unknown Individual – Oral and Maxillofacial Surgery (Dentist), NPI 1093744294

Unknown Individual is a healthcare provider. based in Augusta, Georgia. specializing in Oral and Maxillofacial Surgery (Dentist). They hold a License No. 11758 (GA). The NPI Number for Unknown Individual is 1093744294

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1093744294
Phone
(706) 868-9500
Address
1222 GEORGE C WILSON DR
Deactivation Date
14 June 2023
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

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Provider Addresses for Unknown Individual

  • 1222, George C Wilson Drive, Springfield, Augusta, Richmond County, Georgia, 30909, United States

    AUGUSTA, GA 309094502

    Phone: (706) 868-9500

    Fax: (706) 868-5081

    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.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 30909)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1093744294.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Oral and Maxillofacial Surgery (Dentist). Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Augusta, Georgia. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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