Provider Demographics
NPI:1669816419
Name:STURM, MEAGAN CHAFFINS (DMD)
Entity Type:Individual
Prefix:DR
First Name:MEAGAN
Middle Name:CHAFFINS
Last Name:STURM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MEAGAN
Other - Middle Name:NICOLE
Other - Last Name:CHAFFINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:3188 WINDSOR LAKE DR NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-2372
Mailing Address - Country:US
Mailing Address - Phone:678-522-7130
Mailing Address - Fax:
Practice Address - Street 1:931 MONROE DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1793
Practice Address - Country:US
Practice Address - Phone:678-522-7130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0149051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics