NPIMap

Organization Active NPI

Dental Associates of Southwest Georgia, LLC

  • General Practice Dentistry
  • Cairo, GA
National Provider Identifier
1104843861
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL ASSOCIATES OF SOUTHWEST GEORGIA, LLC
Practice address
718 N Broad St
Cairo, GA 39828-1607
Phone
(229) 377-4204
Fax
(229) 377-7753
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Thomas K Leggett Jr, DMDNPI 1366463960
Title
Owner/Operator
Phone
(229) 377-4204

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

718 N Broad St
Cairo, GA 39828-1607

Mailing address

718 N Broad St
Cairo, GA 39828-1607
Phone (229) 377-4204

National Provider Directory

National Provider Directory

Locations

718 N Broad St
Cairo, GA 39828
Phone (229) 377-4204

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1104843861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 N BROAD ST",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398281607",
            "telephone_number": "229-377-4204",
            "fax_number": "229-377-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 N BROAD ST",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398281607",
            "telephone_number": "229-377-4204",
            "fax_number": "229-377-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ASSOCIATES OF SOUTHWEST GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LEGGETT JR",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "229-377-4204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cairo, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.