Healthcare Provider Details

I. General information

NPI: 1780352120
Provider Name (Legal Business Name): MEGAN ANH-THU DO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5461 MERIDIAN MARK RD STE 200
SANDY SPRINGS GA
30342-4014
US

IV. Provider business mailing address

4760 E BASELINE RD APT 2108
MESA AZ
85206-4691
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-2072
  • Fax:
Mailing address:
  • Phone: 678-897-8465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberD011717
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number37805
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN123602
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: