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CREEKSIDE ORAL SURGERY INC
NPI 1992586143
Dentist - Oral and Maxillofacial Surgery in Johns Creek, GA

Active since October 12, 2023
10700 MEDLOCK BRIDGE RD STE 204, JOHNS CREEK, GA 30097(770) 764-0840 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Creekside Oral Surgery Inc NPPES

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

CREEKSIDE ORAL SURGERY INC (NPI 1992586143) is a healthcare organization registered as an oral and maxillofacial surgery in Johns Creek, Georgia and active in the NPI registry since October 2023. The organization lists Nkemakonam Egolum, Owner, as its authorized official.

NPPES Registry Identity

NPI1992586143
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameCREEKSIDE ORAL SURGERY INC
Location Address10700 MEDLOCK BRIDGE RD STE 204Johns Creek, GA 30097-8455
Mailing Address10700 Medlock Bridge Rd Ste 204Johns Creek, GA 30097-8455
Phone(770) 764-0840
Organization SubpartNo
Authorized OfficialNkemakonam EgolumOwner · (770) 764-0840
Enumeration DateOctober 12, 2023
NPPES CertifiedOctober 12, 2023
✔ NPI 1992586143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
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.
10700 MEDLOCK BRIDGE RD STE 204, Johns Creek, GA 30097
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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.

DR. NKEMAKONAM EGOLUM DDS
Dentist (Oral and Maxillofacial Surgery)
10700 MEDLOCK BRIDGE RD STE 204
JOHNS CREEK, GA 30097
Gwinnett County (770) 764-0840

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 Creekside Oral Surgery Inc's NPI number?

The NPI number for Creekside Oral Surgery Inc is 1992586143. It was assigned to this organization in the NPPES registry on October 12, 2023.

Where is Creekside Oral Surgery Inc located?

Creekside Oral Surgery Inc is located at 10700 Medlock Bridge Rd Ste 204, Johns Creek, GA 30097. The listed phone number is (770) 764-0840.

What is Creekside Oral Surgery Inc's specialty?

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

When was this NPI record last updated?

The NPPES record for Creekside Oral Surgery Inc was last updated on October 12, 2023. 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.