MEDICARE: CHRISTINE MARIE TALEGAONKAR DMD, MD

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
1	122300000X	Dentist	0401419350	VA
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	0438000534	VA
3	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DN124034	GA
4	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DRPM2060	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497314454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE MARIE TALEGAONKAR DMD, MD

Provider Business Mailing Address
First Line	:	1880 W OAK PKWY STE 111
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-2274
Country	:	US
Telephone Number	:	678-905-9066
Fax Number	:

Provider Business Practice Location Address
First Line	:	1880 W OAK PKWY STE 111
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-2274
Country	:	US
Telephone Number	:	678-905-9066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2019
Last Update Date	:	12/05/2025

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Directions to “ CHRISTINE MARIE TALEGAONKAR DMD, MD” Practice Location

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