Dermatology
EPIPHANY DERMATOLOGY OF GEORGIA, LLC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1265544357 · enumerated 2006-08-31 · record updated 2025-03-19. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: GHEORGHE PUSTA, Executive Director · (512) 628-0465
Other names: EPIPHANY DERMATOLOGY
Addresses and phones
- Practice location 874 LANIER AVE W STE 270, FAYETTEVILLE, GA, 30214-7617 (770) 251-5111 Google Maps Apple Maps OpenStreetMap
- Mailing address 7300 RANCH ROAD 2222, BUILDING 1, STE 200, AUSTIN, TX, 78730 (512) 628-0465 Fax (512) 233-2711 Google Maps Apple Maps OpenStreetMap
Specialties
- Dermatology 207N00000X · Primary
- Dermatology, MOHS-Micrographic Surgery 207ND0101X
- Dermatology, Procedural Dermatology 207NS0135X
In this directory
Locations and evidence
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Practice location
FAYETTEVILLE, GA, 302147617
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.