Ga Southern Dental LLC
NPI 1255285607ActiveOrganization· Dentist· Marietta, GA
Dentist in Marietta, Georgia, registered in NPPES in February 2026, part of Ga Southern Dental LLC. The authorized official on file is Erika Melissa Menjivar, Sr. Credentialing Specialist.
Overview
| NPI | 1255285607 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Ga Southern Dental LLC |
| NPI issued | Feb 23, 2026 |
| Last updated in NPPES | Feb 23, 2026 |
| Certified by provider | Feb 23, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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