Ga Southern Dental PPO
NPI 1619898509ActiveOrganization· Dentist· Atlanta, GA
Dentist in Atlanta, Georgia, registered in NPPES in July 2026, part of Ga Sothern Dental PPO. The authorized official on file is Erika Melissa Menjivar, Sr. Credentialing Specialist.
Overview
| NPI | 1619898509 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Ga Sothern Dental PPO |
| NPI issued | Jul 24, 2026 |
| Last updated in NPPES | Jul 24, 2026 |
| Certified by provider | Jul 24, 2026 |
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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