DORIAN GRACE LONGSHORE DMD
NPI 1104355395
Dentist - General Practice in Loganville, GA

Q: What is Dorian Longshore's NPI number?

The NPI number for Dorian Longshore is 1104355395. It was assigned to this individual provider in the NPPES registry on June 9, 2017.

Q: What is Dorian Longshore's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Dorian Longshore was last updated on June 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.

Active since June 09, 2017PECOS Enrolled

4799 ATLANTA HWY # 500, LOGANVILLE, GA 30052(404) 609-4661 Get Directions Write a Review

NPPES record last updated: June 9, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dorian Grace Longshore Dmd NPPES

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

DORIAN GRACE LONGSHORE DMD (NPI 1104355395) is an individual general practice provider in Loganville, Georgia, licensed in Georgia (DN015430) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104355395

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDORIAN GRACE LONGSHORECredential: DMD

Location Address4799 ATLANTA HWY # 500Loganville, GA 30052-7307

Mailing Address1746 Holmes Dr SwConyers, GA 30094-4726 · (470) 255-4855

Phone(404) 609-4661

Sole ProprietorNo

Enumeration DateJune 9, 2017

✔ NPI 1104355395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in GA · DN015430

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

4799 ATLANTA HWY # 500, Loganville, GA 30052

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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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dorian Grace Longshore Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30052 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.

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 Dorian Longshore's NPI number?

The NPI number for Dorian Longshore is 1104355395. It was assigned to this individual provider in the NPPES registry on June 9, 2017.

Where is Dorian Longshore located?

Dorian Longshore practices at 4799 Atlanta Hwy # 500, Loganville, GA 30052. The listed phone number is (404) 609-4661.

What is Dorian Longshore's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Dorian Longshore enrolled in Medicare?

Yes. Dorian Longshore is registered in the Medicare PECOS enrollment system.

What insurance does Dorian Longshore accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 11 other insurers list Dorian Longshore 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.

When was this NPI record last updated?

The NPPES record for Dorian Longshore was last updated on June 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.