Healthcare Provider Details

I. General information

NPI: 1720710130
Provider Name (Legal Business Name): ZENTOOTH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2022
Last Update Date: 06/26/2022
Certification Date: 06/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 PEACHTREE ST NE STE 705
ATLANTA GA
30309-3964
US

IV. Provider business mailing address

999 PEACHTREE ST NE STE 705
ATLANTA GA
30309-3964
US

V. Phone/Fax

Practice location:
  • Phone: 404-885-1441
  • Fax: 404-885-1410
Mailing address:
  • Phone: 404-885-1441
  • Fax: 404-885-1410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: YOUNG OKEKE
Title or Position: CEO/PRESIDENT
Credential: DDS, MSD
Phone: 404-421-0088