MEDICARE: DR. MITCHELL DUANE VAUGHAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	DN012905	GA

General Provider Information

NPI Number	:	1598803868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL DUANE VAUGHAN DDS

Provider Business Mailing Address
First Line	:	1350 SPRING ST NW STE 600
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2870
Country	:	US
Telephone Number	:	770-692-1000
Fax Number	:	570-522-7072

Provider Business Practice Location Address
First Line	:	1150 LAKE HEARN DR STE 170
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-1568
Country	:	US
Telephone Number	:	770-692-1000
Fax Number	:	570-522-7072

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	02/25/2025

Similar Medicare Providers

1558295824 — YOLANDA DENISE KELLY
Practice Location Address:

3371 DOGWOOD DR UNIT 250
ATLANTA, GA
30354-1568

Practice Phone: 770-354-8441
Practice Fax:

1992671887 — AMY KAYNE
Practice Location Address:

1568 E FAIR ST
ATLANTA, GA
30317-2618

Practice Phone: 404-590-7252
Practice Fax:

1215807342 — ORCHID PELVIC HEALTH LLC
Practice Location Address:

1568 E FAIR ST
ATLANTA, GA
30317-2618

Practice Phone: 404-590-7252
Practice Fax:

1699730705 — MARK E CRISPIN MD
Practice Location Address:

5673 PEACHTREE DUNWOODY RD , STE 100
ATLANTA, GA
30342

Practice Phone: 404-257-0064
Practice Fax: 404-257-1568

1225107162 — DR. DAVID BRUCE BROTHERS MD
Practice Location Address:

5673 PEACHTREE DUNWOODY ROAD , SUITE 100
ATLANTA, GA
30342

Practice Phone: 404-257-9888
Practice Fax: 404-257-1568

1700935293 — ANGELA R EVANS NP-C
Practice Location Address:

980 JOHNSON FY RD NE STE 110
ATLANTA, GA
30342-1607

Practice Phone: 404-303-7004
Practice Fax: 404-303-7020

Directions to “ DR. MITCHELL DUANE VAUGHAN DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.