Ga Southern Dental LLC
NPI 1407645021ActiveOrganization· Dentist· Atlanta, GA
Dentist in Atlanta, Georgia, registered in NPPES in May 2025, part of Ga Southern Dental LLC. The authorized official on file is Erika Melissa Menjivar, Sr. Credentialing Specialist.
Overview
| NPI | 1407645021 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Ga Southern Dental LLC |
| NPI issued | May 1, 2025 |
| Last updated in NPPES | May 1, 2025 |
| Certified by provider | May 1, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 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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