Healthcare Provider Details

I. General information

NPI: 1386640167
Provider Name (Legal Business Name): COLIN S. RICHMAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/25/2005
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 PEACHTREE RD NE STE 416
ATLANTA GA
30309-1408
US

IV. Provider business mailing address

2045 PEACHTREE RD NE STE 416
ATLANTA GA
30309-1408
US

V. Phone/Fax

Practice location:
  • Phone: 404-784-7272
  • Fax:
Mailing address:
  • Phone: 404-784-7272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberGA 9285
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: