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ANTWAN LONDELL TREADWAY D.M.D.
NPI 1972616878
Dentist - Oral and Maxillofacial Surgery in Austell, GA

Active since August 16, 2006PECOS Enrolled
1790 MULKEY RD, SUITE 3A, AUSTELL, GA 30106(770) 941-2476(770) 941-5710 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Antwan Londell Treadway D.m.d. NPPES

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

ANTWAN LONDELL TREADWAY D.M.D. (NPI 1972616878) is an individual oral and maxillofacial surgery provider in Austell, Georgia, licensed in Georgia (12209) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1993).

NPPES Registry Identity

NPI1972616878
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameANTWAN LONDELL TREADWAYCredential: D.M.D.
Location Address1790 MULKEY RD, SUITE 3AAustell, GA 30106-1122
Mailing Address1790 Mulkey Rd, Suite 3aAustell, GA 30106-1122 · (770) 941-2476 · Fax (770) 941-5710
Phone(770) 941-2476
Fax(770) 941-5710
Sole ProprietorNo
Medical School CMSOtherGraduated 1993
Enumeration DateAugust 16, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1972616878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in GA · 12209✔ Licensed in FL · DN13765
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

1790 MULKEY RD, Austell, GA 30106
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Other Identifiers 4

Medicaid000849439BGA
Medicare ID-Type Unspecified85BBCKGA
Medicare UPINU77950GA
Medicaid000849439CGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma 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)

Antwan Londell Treadway D.m.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8820177793
PECOS Enrollment IDI20080502000517
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 30106 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.

Other Providers at the Same Location NPPES 20

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

WEST ATLANTA ENDODONTICS
Dentist (Endodontics)
1790 MULKEY RD, SUITE 2
AUSTELL, GA 30106
Cobb County (770) 944-8822
DR. ARLITA D JACKSON D.M.D.
Dentist (General Practice)
1790 MULKEY RD, BLDG 4
AUSTELL, GA 30106
Cobb County (770) 739-4400
MS. KATHY MCKNIGHT LOCKETT NNP
Nurse Practitioner (Neonatal)
1790 MULKEY RD
AUSTELL, GA 30106
Cobb County (404) 277-0916
WELLSTAR MEDICAL GROUP, LLC
Family Medicine
1790 MULKEY RD, SUITE 8-A
AUSTELL, GA 30106
Cobb County (770) 944-1830
WELLSTAR COBB FAMILY MEDICINE, LLC
Family Medicine
1790 MULKEY RD, SUITE 8A
AUSTELL, GA 30106
Cobb County (770) 944-1830
WELLSTAR COBB MEDICAL GROUP, LLC
Internal Medicine
1790 MULKEY RD, SUITE 5A
AUSTELL, GA 30106
Cobb County (770) 792-1055
MRS. PAULOMI SAHIR SHROFF M.D.
Surgery
1790 MULKEY RD, SUITE 9-C
AUSTELL, GA 30106
Cobb County (770) 941-3515
WELLSTAR MEDICAL GROUP, LLC
Otolaryngology
1790 MULKEY RD, SUITE 7
AUSTELL, GA 30106
Cobb County (770) 819-1435

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 Antwan Treadway's NPI number?

The NPI number for Antwan Treadway is 1972616878. It was assigned to this individual provider in the NPPES registry on August 16, 2006.

Where is Antwan Treadway located?

Antwan Treadway practices at 1790 Mulkey Rd Suite 3A, Austell, GA 30106. The listed phone number is (770) 941-2476.

What is Antwan Treadway's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Antwan Treadway enrolled in Medicare?

Yes. Antwan Treadway is registered in the Medicare PECOS enrollment system.

What insurance does Antwan Treadway accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Florida Combined Life and 4 other insurers list Antwan Treadway 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 Antwan Treadway was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.