Basic Information
Provider Information
NPI: 1174079438
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARTIS
FirstName: AKILAH
MiddleName: V
NamePrefix: DR.
NameSuffix:  
Credential: D.D.S
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: STRINGER
OtherFirstName: AKILAH
OtherMiddleName: V
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: D.D.S.
OtherLastNameType: 1
Mailing Information
Address1: 1830 SCENIC HWY N
Address2: STE 220
City: SNELLVILLE
State: GA
PostalCode: 30078
CountryCode: US
TelephoneNumber: 7708449454
FaxNumber:  
Practice Location
Address1: 1830 SCENIC HWY N STE 220
Address2:  
City: SNELLVILLE
State: GA
PostalCode: 300782100
CountryCode: US
TelephoneNumber: 7708449454
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/28/2016
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001XDN015455GAY Dental ProvidersDentistGeneral Practice

No ID Information.


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