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 provides Dentist services 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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