NPI age
20 years
Enumerated 2006-02-18
● Active Type 2 · Organization
Youth Dentistry Of MacOn, Pc
Youth Dentistry Of MacOn, Pc is 1 of 4309 dentist organizations in Georgia.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Zoeller
Vp, Legal Licensing & Credentialing
Last NPPES update
2016-09-06
Source: monthly bulk 2026-05
How this organization compares
Across 4309 active dentist providers in Georgia.
NPI age
20 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-02Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
1536 Eisenhower Pkwy
MacOn, GA 312063130
Mailing address
1536 Eisenhower Pkwy
MacOn, GA 312063130
Authorized official
Linda S Zoeller
Vp, Legal Licensing & Credentialing
📞 4787814333
Individual providers at this organization
7 individual providers on file at this primary practice address.
- Tara Brooks, DDS Dentist NPI 1457497414
- Michelle Gwyn Dentist NPI 1023083631
- Phoeby Lewis, DMD Dentist NPI 1154364396
- Kenia Marmol Mendoza Dentist NPI 1205625225
- Martha Sanchez, DMD Dentist NPI 1588455463
- Jaime Valencia, DMD Dentist NPI 1649824475
- Andrea Wood, DMD Dentist NPI 1285745505
Specialties
-
Dentist PrimaryA general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 1905601 | UNITED CONCORDIA |
| 05 (GA) | 478300670A | |
| 01 (GA) | 539109 | AVESIS |
Practice context
Multi-provider organization. 7 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.