Organization Active NPI

Lake Country Dental Care PC

  • General Practice Dentistry
  • Milledgeville, GA
National Provider Identifier
1053558049
Registry record updated Jan 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LAKE COUNTRY DENTAL CARE PC
Practice address
750 N Cobb St
Ste. 140
Milledgeville, GA 31061-2390
Phone
(478) 452-3768
Fax
(478) 452-2704
NPI assigned
Jan 13, 2009
Last updated
Jan 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2009

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

Authorized official

Name
Bette Lefkove
Title
Practice Administrator
Phone
(478) 452-3768

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

750 N Cobb St
Ste. 140
Milledgeville, GA 31061-2390

Mailing address

750 N Cobb St
Ste. 140
Milledgeville, GA 31061-2390
Phone (478) 452-3768

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231804800000",
    "number": "1053558049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N COBB ST",
            "address_2": "STE. 140",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612390",
            "telephone_number": "478-452-3768",
            "fax_number": "478-452-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N COBB ST",
            "address_2": "STE. 140",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612390",
            "telephone_number": "478-452-3768",
            "fax_number": "478-452-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTRY DENTAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-13",
        "last_updated": "2009-01-13",
        "status": "A",
        "authorized_official_last_name": "LEFKOVE",
        "authorized_official_first_name": "BETTE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "478-452-3768"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milledgeville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; 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.