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JONATHAN MAXWELL CHRISENBERRY THREADGILL D.M.D.
NPI 1093881021
Dentist - Oral and Maxillofacial Surgery in Marietta, GA

Active since November 28, 2006PECOS Enrolled
1000 JOHNSON FERRY RD BLDG H, MARIETTA, GA 30068(770) 977-0364(678) 483-8487 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 21, 2022, Aug 8, 2017 (2 updates tracked since 2017).

About Jonathan Maxwell Chrisenberry Threadgill D.m.d. NPPES

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

JONATHAN MAXWELL CHRISENBERRY THREADGILL D.M.D. (NPI 1093881021) is an individual oral and maxillofacial surgery provider in Marietta, Georgia, licensed in Georgia (DN014348) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1093881021
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameJONATHAN MAXWELL CHRISENBERRY THREADGILLCredential: D.M.D.
Location Address1000 JOHNSON FERRY RD BLDG HMarietta, GA 30068-5518
Mailing Address1000 Johnson Ferry Rd Bldg HMarietta, GA 30068-5518 · (678) 819-6536 · Fax (678) 483-8487
Phone(770) 977-0364
Fax(678) 483-8487
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateNovember 28, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1093881021 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 · DN014348
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.
1000 JOHNSON FERRY RD BLDG H, Marietta, GA 30068
Open in Google Maps ↗

Other Identifiers 1

Other993983PA · United Concordia

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jonathan Maxwell Chrisenberry Threadgill D.m.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3779749361
PECOS Enrollment IDI20120726000126
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 Reassignments

3

Medicare enrollment records show Jonathan Threadgill reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Atlanta Oral & Facial Surgery LLC
0.1 mi
Oral and Maxillofacial Surgery
1000 JOHNSON FERRY RD, BLDG H
Marietta, GA 30068
  • Reassigned Medicare billing, Georgia enrollment
  • 33 clinicians in this Medicare group
NPI 1992738165 (770) 977-0364
Emory Medical Care Foundation Inc
15 mi
Internal Medicine
80 JESSE HILL JR DRIVE, EMCF
Atlanta, GA 30303
  • Reassigned Medicare billing, Georgia enrollment
  • 2,681 clinicians in this Medicare group
NPI 1063452381 (404) 778-7717
North Alabama Oral And Facial Surgery LLC
142 mi
Oral and Maxillofacial Surgery
44 HUGHES RD
Madison, AL 35758
  • Reassigned Medicare billing, Alabama enrollment
NPI 1700273208 (256) 774-3535

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

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110005
Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County
Birthing friendly

Emory Decatur Hospital

Acute Care Hospitals · Decatur, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110076
Location2701 N Decatur RoadDecatur, GA 30033 · De Kalb County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30068 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
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 8

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

DR. JOHN PAUL LABANC D.D.S.
Dentist (Oral and Maxillofacial Surgery)
1000 JOHNSON FERRY RD BLDG H
MARIETTA, GA 30068
Cobb County (770) 977-0364
ATLANTA ORAL & FACIAL SURGERY LLC
Dentist (Oral and Maxillofacial Surgery)
1000 JOHNSON FERRY RD BLDG H
MARIETTA, GA 30068
Cobb County (770) 977-0364
DR. CHRISTOPHER HUGH KRAGOR MD DMD
Dentist (Oral and Maxillofacial Surgery)
1000 JOHNSON FERRY RD BLDG H
MARIETTA, GA 30068
Cobb County (770) 977-0364
JORGE ALBERTO GONZALEZ-OCASIO DMD
Dentist (Oral and Maxillofacial Surgery)
1000 JOHNSON FERRY RD BLDG H
MARIETTA, GA 30068
Cobb County (678) 819-6536
TERESA SKINNER
Dental Assistant
1000 JOHNSON FERRY RD BLDG H
MARIETTA, GA 30068
Cobb County (770) 977-0364
JOSHUA MICHAEL LEVY DMD, MD
Dentist (Oral and Maxillofacial Surgery)
1000 JOHNSON FERRY RD BLDG H
MARIETTA, GA 30068
Cobb County (770) 977-0364
DR. CHRISTOPHER YI DMD
Dentist (Oral and Maxillofacial Surgery)
1000 JOHNSON FERRY RD BLDG H
MARIETTA, GA 30068
Cobb County (770) 977-0364
DR. HENRY KIME BLAIR DMD
Dentist (Oral and Maxillofacial Surgery)
1000 JOHNSON FERRY RD BLDG H
MARIETTA, GA 30068
Cobb County (678) 819-6536

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 Jonathan Threadgill's NPI number?

The NPI number for Jonathan Threadgill is 1093881021. It was assigned to this individual provider in the NPPES registry on November 28, 2006.

Where is Jonathan Threadgill located?

Jonathan Threadgill practices at 1000 Johnson Ferry Rd Bldg H, Marietta, GA 30068. The listed phone number is (770) 977-0364.

What is Jonathan Threadgill's specialty?

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

Is Jonathan Threadgill enrolled in Medicare?

Yes. Jonathan Threadgill is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jonathan Threadgill's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Threadgill reassigns Medicare benefits to 3 organizations: Atlanta Oral & Facial Surgery LLC (Marietta, GA), Emory Medical Care Foundation Inc (Atlanta, GA) and North Alabama Oral And Facial Surgery LLC (Madison, AL). Each 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 Jonathan Threadgill's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jonathan Threadgill accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 12 other insurers list Jonathan Threadgill as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jonathan Threadgill affiliated with any hospitals?

According to CMS data, Jonathan Threadgill is affiliated with Northside Hospital Forsyth and Emory Decatur Hospital.

When was this NPI record last updated?

The NPPES record for Jonathan Threadgill was last updated on July 21, 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.