Healthcare Provider Details

I. General information

NPI: 1053232827
Provider Name (Legal Business Name): JESSICA DANIELA ROJAS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 OGLETHORPE AVE
ATHENS GA
30606-2221
US

IV. Provider business mailing address

2619 SUMMERFIELD WAY
LAWRENCEVILLE GA
30044-3689
US

V. Phone/Fax

Practice location:
  • Phone: 706-425-9445
  • Fax:
Mailing address:
  • Phone: 678-541-1366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN124274
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: