Macon Dentist Office, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MACON DENTIST OFFICE, PC

Practice address

206 Tom Hill Sr Blvd
Suite 106
Macon, GA 31210

Phone

(478) 654-3111

Fax

(478) 246-0074

NPI assigned

Mar 7, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Katie L McCann, DDS

Title

Owner

Phone

(478) 654-3111

Specialties & licenses 1

Addresses

Other names 1

• Macon Dentist Office Doing business as

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1083074868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 TOM HILL SR BLVD",
            "address_2": "SUITE 106",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31210",
            "telephone_number": "478-654-3111",
            "fax_number": "478-246-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACON DENTIST OFFICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-654-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Macon Dentist Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Macon Family Health Center Inc
• Macon Ga Orthodontics

• General Practice Dentistry in Macon, GA
• Providers in Macon, 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 Mar 7, 2016; 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.