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GA SOUTHERN DENTAL LLC
NPI 1255285607
Dentist in Marietta, GA

Active since February 23, 2026
1225 JOHNSON FERRY RD STE 660, MARIETTA, GA 30068(770) 973-6494 Get Directions Write a Review

NPPES record last updated: February 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ga Southern Dental Llc NPPES

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

GA SOUTHERN DENTAL LLC (NPI 1255285607), doing business as Georgia Dental Medicine, is a healthcare organization registered as a dentist in Marietta, Georgia and active in the NPI registry since February 2026. The organization lists Erika Melissa Menjivar, Sr. Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1255285607
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameGA SOUTHERN DENTAL LLC
Location Address1225 JOHNSON FERRY RD STE 660Marietta, GA 30068-2772
Mailing Address5830 Granite Pkwy Ste 780Plano, TX 75024-6775
Phone(770) 973-6494
Organization SubpartYes
Authorized OfficialErika Melissa MenjivarSr. Credentialing Specialist · (469) 596-6137
Enumeration DateFebruary 23, 2026
NPPES CertifiedFebruary 23, 2026
✔ NPI 1255285607 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
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.
1225 JOHNSON FERRY RD STE 660, Marietta, GA 30068
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Other Names 1

Doing Business AsGeorgia Dental Medicine

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

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

IVAN MACHAI WARNER
Dentist (General Practice)
1225 JOHNSON FERRY RD STE 660
MARIETTA, GA 30068
Cobb County (770) 973-6494

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 Ga Southern Dental LLC's NPI number?

The NPI number for Ga Southern Dental LLC is 1255285607. It was assigned to this organization in the NPPES registry on February 23, 2026. The provider is doing business as Georgia Dental Medicine.

Where is Ga Southern Dental LLC located?

Ga Southern Dental LLC is located at 1225 Johnson Ferry Rd Ste 660, Marietta, GA 30068. The listed phone number is (770) 973-6494.

What is Ga Southern Dental LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Ga Southern Dental LLC was last updated on February 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.