Michael Ray Callahan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10836 Issued in GA

Practice address

12991 Jones St
Lavonia, GA 30553-1158

Phone

(706) 356-1477

Fax

(706) 356-7070

NPI assigned

Oct 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083799266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736",
            "address_2": "12991 JONES STREET",
            "city": "LAVONIA",
            "state": "GA",
            "postal_code": "305530736",
            "telephone_number": "706-356-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12991 JONES ST",
            "city": "LAVONIA",
            "state": "GA",
            "postal_code": "305531158",
            "telephone_number": "706-356-1477",
            "fax_number": "706-356-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "MICHAEL",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Lavonia, GA
• Providers in Lavonia, 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 Jul 8, 2007; 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.