NPI age
19 years
Enumerated 2007-03-27
● Active Type 2 · Organization
Oral Surgery Group Of Coastal Georgia, Llc
Oral Surgery Group Of Coastal Georgia, Llc is 1 of 358 dentist organizations in Georgia.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
James
Cfo
Last NPPES update
2018-08-24
Source: monthly bulk 2026-05
How this organization compares
Across 358 active dentist providers in Georgia.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
506 Us Highway 80 W
Pooler, GA 31322
Mailing address
506 Us Highway 80 W
Pooler, GA 313222104
Authorized official
Stephen James, CFO
Cfo
📞 5022548500
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Nicholas Theodotou, BDS, DDS Dentist NPI 1174764039
Specialties
-
Dentist PrimaryThe specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Practice context
Multi-provider organization. 1 individual provider 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.