Ga Southern Dental PPO
NPI 1811723695ActiveOrganization· Dentist· Atlanta, GA
Dentist in Atlanta, Georgia, registered in NPPES in September 2024, part of Ga Southern Dental PPO. The authorized official on file is Erika Melissa Menjivar, Sr. Credentialing Specialist.
Overview
| NPI | 1811723695 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Ga Southern Dental PPO |
| NPI issued | Sep 10, 2024 |
| Last updated in NPPES | Sep 10, 2024 |
| Certified by provider | Sep 10, 2024 |
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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