Dana E Nelson Witherspoon, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

8670 Issued in NC

Practice address

2000 Riverside Parkway, Suite 200
Great Expressions Dental Centers of Georgia, PC
Lawrenceville, GA 30043

Phone

(202) 487-5044

NPI assigned

Jan 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1205167962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 RIVERSIDE PARKWAY, SUITE 200",
            "address_2": "GREAT EXPRESSIONS DENTAL CENTERS OF GEORGIA, PC",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 RIVERSIDE PARKWAY, SUITE 200",
            "address_2": "GREAT EXPRESSIONS DENTAL CENTERS OF GEORGIA, PC",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043",
            "telephone_number": "202-487-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON WITHERSPOON",
        "first_name": "DANA",
        "middle_name": "E",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013754",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8670",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NC",
            "license": "8670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5916374",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Needham, RD, LD
• Derek Manuel Negron Castro, DC
• Jordyn Nehrbauer
• Neighbourhood Pharmacy LLC
• Rachel Elizabeth Nejem, NP-C
• Amethyst Althea Nelson- Preston, RN
• Diamond Nelson, RBT
• Jamilah Nelson
• Jerkiah Nelson
• Karen Bittick Nelson, OTR

• Public Health Dentistry in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Public Health Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.