Magnolia Family Dentistry, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MAGNOLIA FAMILY DENTISTRY, LLC

Practice address

440 Westhaven CT
Grovetown, GA 30813-0760

Phone

(706) 619-1733

Fax

(706) 619-1755

NPI assigned

Feb 21, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Melissa M Jordan, DMDNPI 1306139373

Title

Owner

Phone

(706) 619-1733

Specialties & licenses 1

Addresses

Locations

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.

• Melissa Mobley Jordan, D.M.D.

  • Dentist
  • Grovetown, GA
  • NPI 1306139373
  NPD Authorized official
• Amber Thomas

  • Dentist
  • Grovetown, GA
  • NPI 1114815693
  NPD

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1134925019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 WESTHAVEN CT",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308130760",
            "telephone_number": "706-619-1733",
            "fax_number": "706-619-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WESTHAVEN CT",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308130760",
            "telephone_number": "706-619-1733",
            "fax_number": "706-619-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-619-1733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alaya Martin
• Courtney Noel Matthews, LPC
• Amber Jillian McCall
• Jennifer Sheridan McCarthy, FNP-C

• General Practice Dentistry in Grovetown, GA
• Providers in Grovetown, 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 Feb 21, 2025; 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.