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

Oral an Implant Surgery Specialists, PC

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1396094074

Oral an Implant Surgery Specialists, PC is an Oral & Maxillofacial Surgery (D.M.D.) in Fayetteville, Georgia. Licensed in Georgia. Registered with an NPI since 2012.

Licensed in
GA
In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1260 Highway 54 W Ste 200
Fayetteville, GA 30214-4514
Phone: (770) 461-2101
Fax: (770) 460-1292
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence 007973 (GA)

Record details

NPI number1396094074
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Durwood Johnson — Doctor · (770) 461-2101
NPI enumeratedSeptember 10, 2012
Last updated in NPPESMay 10, 2013
Mailing address1260 Highway 54 W, Suite 200, Fayetteville, GA 30214-4514

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