Les J. Kicklighter, D.M.D., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012401 Issued in GA

Legal business name

LES J. KICKLIGHTER, D.M.D., P.C.

Practice address

512 Gentilly Rd
Statesboro, GA 30458-5149

Phone

(912) 489-4151

NPI assigned

Mar 7, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Les J. Kicklighter, D.M.D.NPI 1417075623

Title

President

Phone

(912) 489-4151

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Les J. Kicklighter, D.M.D.

  • General Practice Dentistry
  • Statesboro, GA
  • NPI 1417075623
  NPD (past) Authorized official

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053442608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 GENTILLY RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585149",
            "telephone_number": "912-489-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 GENTILLY RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585149",
            "telephone_number": "912-489-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LES J. KICKLIGHTER, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KICKLIGHTER",
        "authorized_official_first_name": "LES",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-489-4151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00956007A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra L Lee
• Cynthia Beasley Lee, LPC
• Kashera Lee
• Laci A Lee, MT
• Lindsay Lee, M.S, CCC-SLP
• Mark A Leszczynski, CRNA
• Chad Edward Lewis, P.A.
• Jordyn Lewis, FNP
• Nikiya L Lewis
• Shalli Davis Lewis

• General Practice Dentistry in Statesboro, GA
• Providers in Statesboro, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.