Provider Demographics
NPI:1700849080
Name:FREEMONT, JOI (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOI
Middle Name:
Last Name:FREEMONT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HAPEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1918
Mailing Address - Country:US
Mailing Address - Phone:404-761-1659
Mailing Address - Fax:404-762-1989
Practice Address - Street 1:606 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1918
Practice Address - Country:US
Practice Address - Phone:404-761-1659
Practice Address - Fax:404-762-1989
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11737122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00751363AMedicaid