Active NPI
Brandon Lynch, DDS
- Dentist
- Conyers, GA
National Provider Identifier
1184299984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN122249
- 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, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| DN122249 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ardent Smiles LLC | Current | Accepting new patients | |
| Lilburn Dental Studio | Current | Accepting new patients | |
| Conyers Smiles Dentistry, PC | Past | 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.
-
- Customized Equipment (DME)
- Conyers, GA
- NPI 1194533075
-
- General Practice Dentistry
- Lilburn, GA
- NPI 1205790300
-
dba Conyers Smiles Dentistry
- General Practice Dentistry
- Conyers, GA
- NPI 1255734174
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.