Lynn Baxter Mullis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9956 Issued in GA

Practice address

129 Cherry St
Cochran, GA 31014

Phone

(478) 934-7557

Fax

(478) 934-0093

NPI assigned

Oct 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/blecke-7e5b2025

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013007400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 805",
            "address_2": "129 CHERRY ST",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "310140805",
            "telephone_number": "478-934-7557",
            "fax_number": "478-934-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 CHERRY ST",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "31014",
            "telephone_number": "478-934-7557",
            "fax_number": "478-934-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "LYNN",
        "middle_name": "BAXTER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Cochran, GA
• Providers in Cochran, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.