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General NPI Number Information
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NPI Number | 1548132400
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Entity Type | Individual
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Provider Name | MEGAN CHRISTINA IZUTANI RDH
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Gender | Female
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Dates
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Enumeration Date | 09/20/2025
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Last Update Date | 09/20/2025
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Provider Practice Location Address
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Address Line | 3005 OLD ALABAMA RD STE 320
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City | JOHNS CREEK
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State | GA
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Zip | 30022-1904
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Country | US
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Telephone | 678-404-0794
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Fax |
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Provider Business Mailing Address
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Address Line | 6830 ASHFORD MANOR WAY
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City | CUMMING
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State | GA
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Zip | 30040-6754
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Country | US
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Telephone | 678-404-0794
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH011605
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License Number State | GA
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