SOUTHEAST ORAL DIAGNOSTICS LLC
NPI 1063378966
Dentist - Oral and Maxillofacial Pathology in Alpharetta, GA

Active since January 05, 2026
282 RUCKER RD STE 110, ALPHARETTA, GA 30004(770) 992-4844 Get Directions Write a Review

NPPES record last updated: January 5, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Southeast Oral Diagnostics Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEAST ORAL DIAGNOSTICS LLC (NPI 1063378966) is a healthcare organization registered as an oral and maxillofacial pathology in Alpharetta, Georgia and active in the NPI registry since January 2026. The organization maintains 3 additional practice locations and lists Stephanie Wetzel, Owner/ Dentist, as its authorized official.

NPPES Registry Identity

NPI1063378966
Entity TypeOrganization
Primary Taxonomy1223P0106X
Legal Business NameSOUTHEAST ORAL DIAGNOSTICS LLC
Location Address282 RUCKER RD STE 110Alpharetta, GA 30004-5826
Mailing Address346 Preston AveLexington, KY 40502-1532 · (770) 992-4844
Organization SubpartNo
Authorized OfficialStephanie WetzelOwner/ Dentist · (770) 992-4844
Enumeration DateJanuary 5, 2026
NPPES CertifiedJanuary 5, 2026
NPI 1063378966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial PathologyDental Providers
Taxonomy Code1223P0106X
Definition
The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations.
282 RUCKER RD STE 110, Alpharetta, GA 30004

Secondary Practice Locations 3

Location 1550 Pharr Rd NE Ste 325Atlanta, GA 30305-3450 · Phone (404) 233-8221
Location 2755 Commerce Dr Ste ADecatur, GA 30030-2613 · Phone (404) 378-2331
Location 35555 Peachtree Dunwoody Rd Ste G56Atlanta, GA 30342-1700 · Phone (404) 252-5626

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (Oral and Maxillofacial Pathology)
282 RUCKER RD STE 110
ALPHARETTA, GA 30004

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeast Oral Diagnostics LLC's NPI number?

The NPI number for Southeast Oral Diagnostics LLC is 1063378966. It was assigned to this organization in the NPPES registry on January 5, 2026.

Where is Southeast Oral Diagnostics LLC located?

Southeast Oral Diagnostics LLC is located at 282 Rucker Rd Ste 110, Alpharetta, GA 30004. The listed phone number is (770) 992-4844.

What is Southeast Oral Diagnostics LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Pathology, with taxonomy code 1223P0106X.

When was this NPI record last updated?

The NPPES record for Southeast Oral Diagnostics LLC was last updated on January 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.