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NPI Code Detail

MEDICARE: JONATHAN AHADDIAN DDS

MEDICARE:   JONATHAN  AHADDIAN  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist23591GA

General Provider Information

NPI Number : 1437098100
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN AHADDIAN DDS
Provider Business Mailing Address
First Line : 2413 HEMINGWAY LN # 2413
Second Line :
City : ROSWELL
State : GA
Zip : 30075-7046
Country : US
Telephone Number : 310-990-7766
Fax Number :
Provider Business Practice Location Address
First Line : 2413 HEMINGWAY LN # 2413
Second Line :
City : ROSWELL
State : GA
Zip : 30075-7046
Country : US
Telephone Number : 310-990-7766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2026
Last Update Date : 03/26/2026

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Directions to “ JONATHAN AHADDIAN DDS” Practice Location

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