Individual provider Active NPI

Shirley Jones Lathon

  • General Practice Dentistry
  • Newnan, GA
National Provider Identifier
1164525390
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN011657 Issued in GA
Practice address
1605 Highway 34 E Ste A1
Newnan, GA 30265-2191
Phone
(770) 254-8000
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN011657 GA
General Practice Dentistry 1223G0001X DN011657 GA Primary

Addresses

Primary practice location

1605 Highway 34 E Ste A1
Newnan, GA 30265-2191

Mailing address

2502 N Rocky Point Dr
Suite 1000-Credentialing
Tampa, FL 33607-1421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170829004367 GA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4880967678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Diasti DDS & Associates P.C. Dentist Past Accepting new patients
Oral Health Management PLLC Dentist Past Accepting new patients
Smaltz Family Dental, P.C. General Practice PastSince Feb 11, 2024 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1164525390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 N ROCKY POINT DR",
            "address_2": "SUITE 1000-CREDENTIALING",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 HIGHWAY 34 E STE A1",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652191",
            "telephone_number": "770-254-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES LATHON",
        "first_name": "SHIRLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN011657",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.