Unknown Individual – Ophthalmology Physician, NPI 1629070990

Unknown Individual is a healthcare provider. based in Dalton, Georgia. specializing in Ophthalmology Physician. They hold a License No. 013177 (GA). The NPI Number for Unknown Individual is 1629070990

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1629070990
Phone
(706) 226-2020
Address
1111 PROFESSIONAL BLVD
Deactivation Date
19 December 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

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Provider Addresses for Unknown Individual

  • Professional Boulevard, Dalton, Whitfield County, Georgia, 30722, United States

    DALTON, GA 307202588

    Phone: (706) 226-2020

    Fax: (706) 217-2876

    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 30720)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1629070990.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Ophthalmology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Dalton, Georgia; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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