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

Periodontal Associates PC

Organization Periodontics · NPI 1184845273

Periodontal Associates PC is a Periodontics in Atlanta, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
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

1895 Phoenix Blvd Ste 138
Atlanta, GA 30349
Phone: (770) 996-2900
Fax: (770) 996-0403
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 6518 (GA)

Record details

NPI number1184845273
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Henry Diversi — President · (770) 996-2900
NPI enumeratedMay 2, 2007
Last updated in NPPESAugust 22, 2020
Mailing address1895 Phoenix Blvd, Ste 138, Atlanta, GA 30349

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