Lake Oconee Oral and Maxillofacial Surgery, P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN012341 Issued in GA

Legal business name

LAKE OCONEE ORAL AND MAXILLOFACIAL SURGERY, P.C.

Practice address

1031 Founders Row
Greensboro, GA 30642

Phone

(706) 454-1500

Fax

(706) 454-1501

NPI assigned

May 24, 2012

Organization subpart

No

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

Authorized official

Name

Dr. David Clay Miller, DDSNPI 1992861686

Title

President

Phone

(706) 454-1500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• David Clay Miller, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Greensboro, GA
  • NPI 1992861686
  NPD (past) Authorized official

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1154681195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 FOUNDERS ROW",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "30642",
            "telephone_number": "706-454-1500",
            "fax_number": "706-454-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 FOUNDERS ROW",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "30642",
            "telephone_number": "706-454-1500",
            "fax_number": "706-454-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE OCONEE ORAL AND MAXILLOFACIAL SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CLAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-454-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN012341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Medical Center
• Lake Oconee Assisted Living Home
• Lake Oconee Assisted Living, LLC (Kingdom Care Service Center)
• Lake Oconee Endodontics, LLC
• Lake Oconee Foot and Ankle LLC
• Lake Oconee Orthopedics, LLC
• Lakeside Pediatric Dentistry, LLC
• Michelle M Lamm, AGNP-C
• Joshua M Lang, DO
• Amanda R Lanier, NP

• Oral and Maxillofacial Surgery (Dentist) in Greensboro, GA
• Providers in Greensboro, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.