Healthcare Provider Details

I. General information

NPI: 1922304559
Provider Name (Legal Business Name): OSCAR PINO D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2011
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 THE EXCHANGE SE STE 600
ATLANTA GA
30339-2083
US

IV. Provider business mailing address

1820 THE EXCHANGE SE STE 600
ATLANTA GA
30339-2083
US

V. Phone/Fax

Practice location:
  • Phone: 770-953-1752
  • Fax: 770-953-6470
Mailing address:
  • Phone: 770-953-1752
  • Fax: 770-953-6470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN122899
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: