Active NPI
Charolette B Lee
- Dental Assistant
- Fort Benning, GA
National Provider Identifier
1073270336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- Practice address
- Salomon Dental Clinic
11TH Airborne Division Road
Fort Benning, GA 31905 - Phone
- (706) 544-9072
- NPI assigned
- Nov 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Primary |
Addresses
Primary practice location
Salomon Dental Clinic
11TH Airborne Division Road
Fort Benning, GA 31905
Mailing address
599 Laurel Ridge LN
Cataula, GA 31804-2866
Phone (706) 566-3037
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637539200000",
"number": "1073270336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "599 LAUREL RIDGE LN",
"city": "CATAULA",
"state": "GA",
"postal_code": "318042866",
"telephone_number": "706-566-3037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SALOMON DENTAL CLINIC",
"address_2": "11TH AIRBORNE DIVISION ROAD",
"city": "FORT BENNING",
"state": "GA",
"postal_code": "31905",
"telephone_number": "706-544-9072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "CHAROLETTE",
"middle_name": "B",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-22",
"last_updated": "2021-11-22",
"certification_date": "2021-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Benning, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.