OrganizationActive
Ga Southern Dental Ppo
NPI 1417783291 · Dentist · Suwanee, GA
Ga Southern Dental Ppo is a Dentist organization in Suwanee, GA (NPI 1417783291).
Provider details
- NPI number
- 1417783291
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Parent organization
- Ga Southern Dental Ppo
- Organization subpart
- Yes
- Authorized official
- Erika Menjivar, Sr. Credentialing Specialist(469) 596-6137
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr 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
1000 Peachtree Industrial Blvd Ste 10
Suwanee, GA 30024-1977
Phone: (770) 614-4666
Street-level locationGet directions
Mailing address
5830 Granite Pkwy Ste 780
Plano, TX 75024-6775
Other names (DBA / former)
- Doing business as
- Suwanee Creek Dentistry
Registry dates
- Enumerated
- 2024-09-10
- Last updated
- 2026-03-17
- Certified
- 2026-03-17
Frequently asked questions
- What is Ga Southern Dental Ppo's NPI number?
- Ga Southern Dental Ppo's National Provider Identifier (NPI) is 1417783291, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ga Southern Dental Ppo?
- Ga Southern Dental Ppo is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Ga Southern Dental Ppo located?
- Ga Southern Dental Ppo's practice location on file with NPPES is 1000 Peachtree Industrial Blvd Ste 10, Suwanee, GA 30024-1977.
- What is Ga Southern Dental Ppo's phone number?
- The practice phone number listed in the NPPES registry for Ga Southern Dental Ppo is (770) 614-4666.
- Who is the authorized official for Ga Southern Dental Ppo?
- The authorized official listed on Ga Southern Dental Ppo's NPPES record is Erika Menjivar, Sr. Credentialing Specialist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ga Southern Dental Ppo's NPI active?
- Yes — Ga Southern Dental Ppo's NPI (1417783291) is active in the NPPES registry as of the last update on 2026-03-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.