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

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1093881021

Jonathan Maxwell Chrisenberry Threadgill, DMD is a Maxillofacial Surgery in Marietta, Georgia. Qualified in 2012, 14 years ago. Practices with Atlanta Oral and Facial Surgery LLC, a 24-clinician group. Licensed in Georgia.

Years since qualifying
14
Licensed in
GA
In the registry since
2006
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

1000 Johnson Ferry Rd Bldg H
Marietta, GA 30068-5518
Phone: (770) 977-0364
Fax: (678) 483-8487
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence DN014348 (GA)

Record details

NPI number1093881021
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedNovember 28, 2006
Last updated in NPPESJuly 21, 2022
Mailing address1000 Johnson Ferry Rd Bldg H, Marietta, GA 30068-5518

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMAXILLOFACIAL SURGERY
Also practisesORAL SURGERY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Atlanta Oral And Facial Surgery Llc — 24 clinicians
Accepts Medicare assignment Not indicated

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