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SOUTHWEST MAXILLOFACIAL SURGERY & IMPLANT CENTER
NPI 1073743795
Dentist - Oral and Maxillofacial Surgery in Atlanta, GA

Active since July 15, 2009
3885 PRINCETON LAKES WAY SW, 406, ATLANTA, GA 30331(404) 629-6610(404) 629-6630 Get Directions Write a Review

NPPES record last updated: July 15, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southwest Maxillofacial Surgery & Implant Center NPPES

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

SOUTHWEST MAXILLOFACIAL SURGERY & IMPLANT CENTER (NPI 1073743795) is a healthcare organization registered as an oral and maxillofacial surgery in Atlanta, Georgia and active in the NPI registry since July 2009. The organization lists Jacques Leonel Gordon, President, as its authorized official.

NPPES Registry Identity

NPI1073743795
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameSOUTHWEST MAXILLOFACIAL SURGERY & IMPLANT CENTER
Location Address3885 PRINCETON LAKES WAY SW, 406Atlanta, GA 30331-5589
Mailing Address3885 Princeton Lakes Way Sw, 406Atlanta, GA 30331-5589 · (404) 629-6610 · Fax (404) 629-6630
Phone(404) 629-6610
Fax(404) 629-6630
Organization SubpartNo
Authorized OfficialJacques Leonel GordonPresident · (404) 629-6610
Enumeration DateJuly 15, 2009
✔ NPI 1073743795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in GA · DN013463
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

3885 PRINCETON LAKES WAY SW, Atlanta, GA 30331
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Other Identifiers 1

Medicaid457061566AGA

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 20

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

SOUTHCARE PHYSICIANS GROUP OBSTETRICS & GYNECOLOGY
Obstetrics & Gynecology
3885 PRINCETON LAKES WAY SW, SUITE 412
ATLANTA, GA 30331
Fulton County (404) 466-1006
WELLSTAR MEDICAL GROUP, LLC
Internal Medicine
3885 PRINCETON LAKES WAY SW, SUITE 300
ATLANTA, GA 30331
Fulton County (404) 344-0059
DR. CHARIS JEWELLE TRENCH-SIMMONS M.D.
Obstetrics & Gynecology
3885 PRINCETON LAKES WAY SW, SUITE 412
ATLANTA, GA 30331
Fulton County (678) 365-2322
PICKENS ANDREW PATTERSON III MD
Pain Medicine (Interventional Pain Medicine)
3885 PRINCETON LAKES WAY SW, STE 400
ATLANTA, GA 30331
Fulton County (678) 733-9666
THE INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER PC
Pain Medicine (Interventional Pain Medicine)
3885 PRINCETON LAKES WAY SW, SUITE 225
ATLANTA, GA 30331
Fulton County (770) 929-9033
CAMP CREEK LLC
Specialist
3885 PRINCETON LAKES WAY SW, STE 400
ATLANTA, GA 30331
Fulton County (404) 344-6575
SOUTHERN CRESCENT PHYSICIANS GROUP, INC
Psychiatry & Neurology (Neurology)
3885 PRINCETON LAKES WAY SW
ATLANTA, GA 30331
Fulton County (770) 996-3190
GRACE MEDICAL PRACTICE LLC
Clinic/Center (Primary Care)
3885 PRINCETON LAKES WAY SW, SUITE 402
ATLANTA, GA 30331
Fulton County (404) 349-0496

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 Southwest Maxillofacial Surgery & Implant Center's NPI number?

The NPI number for Southwest Maxillofacial Surgery & Implant Center is 1073743795. It was assigned to this organization in the NPPES registry on July 15, 2009.

Where is Southwest Maxillofacial Surgery & Implant Center located?

Southwest Maxillofacial Surgery & Implant Center is located at 3885 Princeton Lakes Way SW 406, Atlanta, GA 30331. The listed phone number is (404) 629-6610.

What is Southwest Maxillofacial Surgery & Implant Center's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Southwest Maxillofacial Surgery & Implant Center was last updated on July 15, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.