Unknown Individual – Oral and Maxillofacial Surgery (Dentist), NPI 1124022876

Unknown Individual is a healthcare provider. based in Marietta, Georgia. specializing in Oral and Maxillofacial Surgery (Dentist). They hold a License No. DN07281 (GA). The NPI Number for Unknown Individual is 1124022876

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124022876
Phone
(770) 977-0364
Address
1000 JOHNSON FERRY RD
Deactivation Date
22 November 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

  • Creative Dentistry, 1000, Johnson Ferry Road Northeast, Mount Bethel, Marietta, Georgia, 30068, United States

    BLDG H

    MARIETTA, GA 300685518

    Phone: (770) 977-0364

    Fax: (678) 819-6531

    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.

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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 30068)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1124022876.
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 services align with Unknown Individual's listing?
Unknown Individual's public classification highlights 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 Marietta, Georgia. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

Similar Providers

DR. JAMES RALPH SMOUSE (D.D.S.)

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DR. ROBERT CARL WUNDERLE (D.D.S.)

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DR. BARTON L JR. MCGHEE (D.D.S.)

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DR. ROGER A MEYER (M.D., D.D.S.)

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DR. STEVEN JULE LEVY (D.D.S.)

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DR. RICHARD A MEADERS (D.M.D.)

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DR. PAUL J. II SCHANER (D.M.D.)

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DR. SHAHROKH C BAGHERI (M.D. D.M.D.)

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DR. DONALD R NUNN (M.D. D.D.S.)

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