Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ga Southern Dental PPO

Organization Dentist · NPI 1619898509

Ga Southern Dental PPO is a Dentist in Atlanta, Georgia. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

1820 The Exchange SE Ste 700
Atlanta, GA 30339-2083
Phone: (770) 980-0232
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1619898509
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationGa Sothern Dental PPO
Authorized official Erika Menjivar — Sr. Credentialing Specialist · (469) 596-6137
Other names Mallard Cove Dental
NPI enumeratedJuly 24, 2026
Last updated in NPPESJuly 24, 2026
Certification dateJuly 24, 2026
Mailing address5830 Granite Pkwy Ste 780, Plano, TX 75024-6775

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