EXECUTIVE PARK DENTISTRY, P.C.
NPI 1124373139
Dentist in Atlanta, GA

Active since July 16, 2012
17 EXECUTIVE PARK DR NE, SUITE 100, ATLANTA, GA 30329(404) 633-0715 Get Directions Write a Review

NPPES record last updated: July 16, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Executive Park Dentistry, P.c. NPPES

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

EXECUTIVE PARK DENTISTRY, P.C. (NPI 1124373139) is a healthcare organization registered as a dentist in Atlanta, Georgia and active in the NPI registry since July 2012. The organization lists Omar S Damji, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1124373139
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameEXECUTIVE PARK DENTISTRY, P.C.
Location Address17 EXECUTIVE PARK DR NE, SUITE 100Atlanta, GA 30329-2251
Mailing Address17 Executive Park Dr Ne, Suite 100Atlanta, GA 30329-2251
Organization SubpartNo
Authorized OfficialOmar S DamjiOwner/dentist · (404) 664-6876
Enumeration DateJuly 16, 2012
NPI 1124373139 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License Licensed in GA · DN012967
Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

17 EXECUTIVE PARK DR NE, Atlanta, GA 30329

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

Accepted Insurance

Other Providers at the Same Location NPPES 2

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

Clinic/Center (Physical Therapy)
17 EXECUTIVE PARK DR NE, SUITE 680
ATLANTA, GA 30329
Art Therapist
17 EXECUTIVE PARK DR NE
ATLANTA, GA 30329

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 Executive Park Dentistry, P.C.'s NPI number?

The NPI number for Executive Park Dentistry, P.C. is 1124373139. It was assigned to this organization in the NPPES registry on July 16, 2012.

Where is Executive Park Dentistry, P.C. located?

Executive Park Dentistry, P.C. is located at 17 Executive Park Dr NE Suite 100, Atlanta, GA 30329. The listed phone number is (404) 633-0715.

What is Executive Park Dentistry, P.C.'s specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Executive Park Dentistry, P.C. accept?

Health plans from UnitedHealthcare list Executive Park Dentistry, P.C. 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 Executive Park Dentistry, P.C. was last updated on July 16, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.