1. Home
  2. Directory
  3. Georgia
  4. Atlanta
  5. Dermatology
  6. NPI Profile

EXPERIENCE DERMATOLOGY LLC
NPI 1659115145
Dermatology in Atlanta, GA

Active since June 20, 2024CLIA 11D2311654 · Microscopy
17 EXECUTIVE PARK DR NE STE 115, ATLANTA, GA 30329(404) 737-2333(404) 737-2444 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Experience Dermatology Llc NPPES

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

EXPERIENCE DERMATOLOGY LLC (NPI 1659115145) is a healthcare organization registered as a dermatology in Atlanta, Georgia and active in the NPI registry since June 2024. The organization holds a CLIA Microscopy certificate valid through September 25, 2026 and lists Zachary Warren Eyre, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1659115145
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameEXPERIENCE DERMATOLOGY LLC
Location Address17 EXECUTIVE PARK DR NE STE 115Atlanta, GA 30329-2222
Mailing Address17 Executive Park Dr Ne Ste 115Atlanta, GA 30329-2222 · (404) 737-2333 · Fax (404) 737-2444
Phone(404) 737-2333
Fax(404) 737-2444
Organization SubpartNo
Authorized OfficialZachary Warren EyreOwner/physician · (801) 822-8565
Enumeration DateJune 20, 2024
NPPES CertifiedJune 15, 2024
✔ NPI 1659115145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
17 EXECUTIVE PARK DR NE STE 115, Atlanta, GA 30329
Open in Google Maps ↗

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 11D2311654

Experience Dermatology · Atlanta, GA
Active · expires Sep 25, 2026
CLIA Number11D2311654
Laboratory TypePhysician Office
Certificate Effective DateSeptember 26, 2024
Certificate Expiration DateSeptember 25, 2026
Laboratory DirectorZachary W. Eyre
Laboratory Phone(404) 737-2333
Laboratory LocationExperience Dermatology17 Executive Park Drive, Suite 115, Atlanta, GA 30329
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

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

DR. ZACHARY EYRE M.D., MBA
Dermatology
17 EXECUTIVE PARK DR NE STE 115
ATLANTA, GA 30329
Dekalb County (404) 737-2333

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 Experience Dermatology LLC's NPI number?

The NPI number for Experience Dermatology LLC is 1659115145. It was assigned to this organization in the NPPES registry on June 20, 2024.

Where is Experience Dermatology LLC located?

Experience Dermatology LLC is located at 17 Executive Park Dr NE Ste 115, Atlanta, GA 30329. The listed phone number is (404) 737-2333.

What is Experience Dermatology LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Experience Dermatology LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D2311654) is associated with this NPI, valid through September 25, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Experience Dermatology LLC was last updated on June 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.