ANTWAN LONDELL TREADWAY D.M.D.
NPI 1972616878
Dentist - Oral and Maxillofacial Surgery in Austell, GA
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, is affiliated with Emory Decatur Hospital, and is a graduate of Other (1993).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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).
Medicare Billing Reassignment
Medicare enrollment records show Antwan Treadway reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Marietta, GA 30068
- Reassigned Medicare billing, Georgia enrollment
- 33 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Emory Decatur Hospital
Acute Care Hospitals · Decatur, GAWellstar Douglas Medical Center
Acute Care Hospitals · Douglasville, GAPhysician 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.
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.
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.
Which organization bills Medicare for Antwan Treadway's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Antwan Treadway reassigns Medicare benefits to Atlanta Oral & Facial Surgery LLC (Marietta, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Antwan Treadway's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
Is Antwan Treadway affiliated with any hospitals?
According to CMS data, Antwan Treadway is affiliated with Emory Decatur Hospital and Wellstar Douglas Medical Center.
When was this NPI record last updated?
The NPPES record for Antwan Treadway was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Antwan Londell Treadway, D.M.D. · NPI 1972616878
Oral and Maxillofacial Surgery provider in Austell, Georgia. Individual provider, active in the CMS NPPES registry since August 16, 2006.
## Identity
- **NPI:** 1972616878 (Entity type: Individual)
- **Enumerated:** August 16, 2006
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **State license:** 12209 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1790 MULKEY RD, SUITE 3A, Austell, GA 30106-1122
- **Phone:** (770) 941-2476 · **Fax:** (770) 941-5710
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Atlanta Oral & Facial Surgery LLC (NPI 1992738165, Marietta, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1993
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicaid 000849439B (GA); Medicare ID-Type Unspecified 85BBCK (GA); Medicare UPIN U77950 (GA); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1972616878) · Data from the CMS NPPES public registry.