Healthcare Provider Details

I. General information

NPI: 1831027085
Provider Name (Legal Business Name): JANICE ROUNTREE, ROUNTREE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 W PEACHTREE ST NW STE 100
ATLANTA GA
30309-3863
US

IV. Provider business mailing address

1556 LITTLE PINE MOUNTAIN RD # 20288
JASPER GA
30143-7576
US

V. Phone/Fax

Practice location:
  • Phone: 404-381-8586
  • Fax:
Mailing address:
  • Phone: 404-538-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number4582
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: