Active NPI
Kevin Lassiter, D.M.D.
- Prosthodontics
- Fort Stewart, GA
National Provider Identifier
1043621493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- D-4521
- Practice address
- 343 Warrior Rd
Building 2115
Fort Stewart, GA 31314 - Phone
- (912) 767-1536
- NPI assigned
- May 19, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | D-4521 | ID | Primary |
| Dentist | 122300000X | D-4521 | ID |
Addresses
Primary practice location
343 Warrior Rd
Building 2115
Fort Stewart, GA 31314
Mailing address
343 Warrior Rd
BLDG 2115
Fort Stewart, GA 31314
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-4521 | ID | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kevin M. Lassiter, PLLC | Prosthodontics | Current | Accepting new patients |
| US Army | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Prosthodontics
- Phoenix, AZ
- NPI 1427916246
-
- Dental Clinic/Center
- NPI 1184689960
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679270400000",
"number": "1043621493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "343 WARRIOR RD",
"address_2": "BLDG 2115",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "31314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "343 WARRIOR RD",
"address_2": "BUILDING 2115",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "31314",
"telephone_number": "912-767-1536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LASSITER",
"first_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-19",
"last_updated": "2023-03-20",
"certification_date": "2023-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "ID",
"license": "D-4521",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ID",
"license": "D-4521",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Stewart, GA
- Christine Shanan Lamm-Barr, SOCIAL WORKER
- Mary Jacques Henri Lamour Jr., MD
- Christopher Scott Lancaster, PHARMD
- Yvonne Kimberly Larochelle, DPT,ATC,MTC
- Cody Lassiter
- Crystal Gail Lastinger, RN
- William Frank Latimer, ORTHOPAEDIC TECH
- Sakarrai Kiev Lavallee, RDN
- John Robert Lavell, LCSW
- Jerome Lavis, LPC-S, LMFT, LCDC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.