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DR. SANDRA NICOLE JACKSON DENT M.D.
NPI 1063640563
Internal Medicine in Snellville, GA

Active since June 23, 2009PECOS EnrolledAccepts Medicare Assignment
2240 FOUNTAIN DR, SNELLVILLE, GA 30078(770) 978-5000 Get Directions Write a Review

NPPES record last updated: January 10, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 10, 2022, Jul 22, 2021 (2 updates tracked since 2021).

About Dr. Sandra Nicole Jackson Dent M.d. NPPES

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

DR. SANDRA NICOLE JACKSON DENT M.D. (NPI 1063640563) is an individual internal medicine provider in Snellville, Georgia, licensed in Illinois (336.091542) and active in the NPI registry since June 2009. She is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1063640563
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. SANDRA NICOLE JACKSON DENTCredential: M.D.
Location Address2240 FOUNTAIN DRSnellville, GA 30078-2919
Mailing Address2240 Fountain DrSnellville, GA 30078-2919 · (770) 978-5000
Phone(770) 978-5000
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateJune 23, 2009
Last NPPES UpdateJanuary 10, 20222 updates tracked since enumeration
NPPES CertifiedJuly 22, 2021
✔ NPI 1063640563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 336.091542
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPediatricsTaxonomy 208000000X · License 336.091542 (IL)
2240 FOUNTAIN DR, Snellville, GA 30078
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sandra Nicole Jackson Dent M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476708967
PECOS Enrollment IDI20171213000558
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sandra Jackson Dent reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Southeast Permanente Medical Group
20 mi
Internal Medicine
3495 PIEDMONT ROAD NE, NINE PIEDMONT CENTER
Atlanta, GA 30305
  • Reassigned Medicare billing, Georgia enrollment
  • 1,389 clinicians in this Medicare group
NPI 1245266956 (404) 364-3821

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30078 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

DR. LAKESHA MARIE DAVISON MD
Pediatrics
2240 FOUNTAIN DR, KAISER PERMANENTE SNELLVILLE MEDICAL CENTER
SNELLVILLE, GA 30078
Gwinnett County (404) 296-7133
KAISER PERMANENTE
Clinical Medical Laboratory
2240 FOUNTAIN DR
SNELLVILLE, GA 30078
Gwinnett County (770) 978-5400
SHATAUNDIA NYRAE FOREMAN NP-C
Nurse Practitioner (Family)
2240 FOUNTAIN DR
SNELLVILLE, GA 30078
Gwinnett County (404) 365-0966
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Pharmacy (Managed Care Organization Pharmacy)
2240 FOUNTAIN DR
SNELLVILLE, GA 30078
Gwinnett County (770) 978-5399
DEANNE LAMBERT RPH
Pharmacist (Ambulatory Care)
2240 FOUNTAIN DR
SNELLVILLE, GA 30078
Gwinnett County (770) 978-5402
HOPE JENAE GALLOWAY MD
Family Medicine
2240 FOUNTAIN DR, KAISER PERMANENTE SNELLVILLE MEDICAL CENTER
SNELLVILLE, GA 30078
Gwinnett County (770) 978-5427

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 Sandra Jackson Dent's NPI number?

The NPI number for Sandra Jackson Dent is 1063640563. It was assigned to this individual provider in the NPPES registry on June 23, 2009.

Where is Sandra Jackson Dent located?

Sandra Jackson Dent practices at 2240 Fountain Dr, Snellville, GA 30078. The listed phone number is (770) 978-5000.

What is Sandra Jackson Dent's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Sandra Jackson Dent enrolled in Medicare?

Yes. Sandra Jackson Dent is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Sandra Jackson Dent's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sandra Jackson Dent reassigns Medicare benefits to The Southeast Permanente Medical Group (Atlanta, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sandra Jackson Dent's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sandra Jackson Dent was last updated on January 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.