Individual provider Active NPI

Brandon Lynch, DDS

  • Dentist
  • Conyers, GA
National Provider Identifier
1184299984
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN122249 Issued in GA
Practice address
2239 Highway 20 SE Ste H
Conyers, GA 30013-2087
Phone
(770) 921-3565
NPI assigned
May 24, 2021
Last updated
May 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN122249 GA Primary

Addresses

Primary practice location

2239 Highway 20 SE Ste H
Conyers, GA 30013-2087

Mailing address

93 Rooks LN
Monticello, GA 31064-6725
Phone (678) 612-1457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN122249GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ardent Smiles LLC CurrentSince Dec 29, 2024 Accepting new patients
Lilburn Dental Studio CurrentSince Dec 14, 2025 Accepting new patients
Conyers Smiles Dentistry, PC PastSince Jun 22, 2021 Accepting new patients

Locations

1380 Milstead Ave NE
Ste A
Conyers, GA 30012
Phone (678) 612-1457

4051 Stone Mountain Hwy
Ste F101
Lilburn, GA 30047
Phone (678) 691-9064

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1184299984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 ROOKS LN",
            "city": "MONTICELLO",
            "state": "GA",
            "postal_code": "310646725",
            "telephone_number": "678-612-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 HIGHWAY 20 SE STE H",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132087",
            "telephone_number": "770-921-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN122249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.