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 1902695521

Ga Southern Dental PPO is a Dentist in Marietta, Georgia. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

365 Villa Rica Way SW
Marietta, GA 30064-5727
Phone: (770) 428-1999
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 number1902695521
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationGa Southern Dental PPO
Authorized official Erika Menjivar — Sr. Credentialing Specialist · (469) 596-6137
Other names Robert Gittelman Dds
NPI enumeratedMay 1, 2025
Last updated in NPPESMay 1, 2025
Certification dateMay 1, 2025
Mailing address5830 Granite Pkwy Ste 780, Plano, TX 75024-6775

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