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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

GA SOUTHERN DENTAL PPO
NPI 1619898509
Dentist in Atlanta, GA

Active since July 24, 2026
1820 THE EXCHANGE SE STE 700, ATLANTA, GA 30339(770) 980-0232 Get Directions Write a Review

NPPES record added: July 24, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ga Southern Dental Ppo NPPES

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

GA SOUTHERN DENTAL PPO (NPI 1619898509), doing business as Mallard Cove Dental, is a healthcare organization registered as a dentist in Atlanta, Georgia and active in the NPI registry since July 2026. The organization lists Erika Melissa Menjivar, Sr. Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1619898509
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameGA SOUTHERN DENTAL PPO
Location Address1820 THE EXCHANGE SE STE 700Atlanta, GA 30339-2083
Mailing Address5830 Granite Pkwy Ste 780Plano, TX 75024-6775
Phone(770) 980-0232
Organization SubpartYesParent: Ga Sothern Dental Ppo
Authorized OfficialErika Melissa MenjivarSr. Credentialing Specialist · (469) 596-6137
Enumeration DateJuly 24, 2026
NPPES CertifiedJuly 24, 2026
✔ NPI 1619898509 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.

1820 THE EXCHANGE SE STE 700, Atlanta, GA 30339
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Other Names 1

Doing Business AsMallard Cove Dental

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.

GA SOUTHERN DENTAL LLC
Dentist
1820 THE EXCHANGE SE STE 700
ATLANTA, GA 30339
Cobb County (770) 980-0232

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 Ppo's NPI number?

The NPI number for Ga Southern Dental Ppo is 1619898509. It was assigned to this organization in the NPPES registry on July 24, 2026. The provider is doing business as Mallard Cove Dental.

Where is Ga Southern Dental Ppo located?

Ga Southern Dental Ppo is located at 1820 The Exchange SE Ste 700, Atlanta, GA 30339. The listed phone number is (770) 980-0232.

What is Ga Southern Dental Ppo'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 Ppo was last updated on July 24, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.