P Praxis·MD
● Active Type 2 · Organization

Athens-Oconee Skin Cancer & Dermatology, Llc

Dermatology·Watkinsville, GA· NPI 1790989291 · Enumerated 2007 · 18 years on NPI
Athens-Oconee Skin Cancer & Dermatology, Llc is 1 of 29 dermatology organizations in Georgia.
NPI age
18 years
Enumerated 2007-06-11
Primary specialty
Dermatology
Plus 2 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Bulengo
Owner
Last NPPES update
2025-09-11
Source: monthly bulk 2026-05

How this organization compares

Across 29 active dermatology providers in Georgia.

NPI age
18 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
2
In the 37% of peers with subspecialties

NPI lifetime · 2007 → 2026

2007-06Enumerated in NPPES
2007 2026

Where they practice

Primary practice location
1582 Mars Hill Rd, Suite A
Watkinsville, GA 306774836
📞 7067697546fax 7067692443
Mailing address
1582 Mars Hill Rd, Suite A
Watkinsville, GA 306774836
📞 7067697546fax 7067692443

Authorized official

Stella Maries Bulengo, M.D.
Owner
📞 7067697546

Individual providers at this organization

1 individual provider on file at this primary practice address.

Specialties

  • Dermatology Primary
    Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery,...
    GA license #050931 taxonomy 207NS0135X
  • Dermatology
    A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The...
    GA license #050931 taxonomy 207N00000X
  • Dermatology
    A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue...
    GA license #050931 taxonomy 207ND0900X

Identifiers

TypeValueNotes
01 (GA) 050931 LICENSE
01 1194717447 NPI INDIVIDUAL

Other names on file (1)

Doing-business-as, former, and alternate names recorded by NPPES.

  • OCONEE DERMATOPATHOLOGY
    Type code 5 recorded 2007-06-11

Practice context

Multi-provider organization. 1 individual provider on file at this primary address.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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