Professional Dental Alliance of Lilburn, LLC
NPI 1710544960ActiveOrganization· Dentist, General Practice· Lilburn, GA
Dentist, General Practice in Lilburn, Georgia, registered in NPPES in May 2019. The authorized official on file is Jessica Barrette, Credentialing Specialist.
Overview
| NPI | 1710544960 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 23, 2019 |
| Last updated in NPPES | May 23, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
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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