OrganizationActive
Executive Park Dentistry, P.C.
NPI 1124373139 · Dentist · Atlanta, GA
Executive Park Dentistry, P.C. is a Dentist organization in Atlanta, GA (NPI 1124373139).
Provider details
- NPI number
- 1124373139
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Omar Damji, Owner/Dentist(404) 664-6876
- License
- DN012967 (GA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
17 Executive Park Dr Ne
Suite 100
Atlanta, GA 30329-2251
Phone: (404) 633-0715
Approximate (ZIP-level) locationGet directions
Mailing address
17 Executive Park Dr Ne
Atlanta, GA 30329-2251
Registry dates
- Enumerated
- 2012-07-16
- Last updated
- 2012-07-16
Frequently asked questions
- What is Executive Park Dentistry, P.C.'s NPI number?
- Executive Park Dentistry, P.C.'s National Provider Identifier (NPI) is 1124373139, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Executive Park Dentistry, P.C.?
- Executive Park Dentistry, P.C. is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Executive Park Dentistry, P.C. located?
- Executive Park Dentistry, P.C.'s practice location on file with NPPES is 17 Executive Park Dr Ne, Atlanta, GA 30329-2251.
- What is Executive Park Dentistry, P.C.'s phone number?
- The practice phone number listed in the NPPES registry for Executive Park Dentistry, P.C. is (404) 633-0715.
- Who is the authorized official for Executive Park Dentistry, P.C.?
- The authorized official listed on Executive Park Dentistry, P.C.'s NPPES record is Omar Damji, Owner/Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Executive Park Dentistry, P.C.'s NPI active?
- Yes — Executive Park Dentistry, P.C.'s NPI (1124373139) is active in the NPPES registry as of the last update on 2012-07-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.