Wallis Hobby, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013114 Issued in GA

Practice address

120 E College Ave
Ashburn, GA 31714-5209

Phone

(229) 326-4801

NPI assigned

Mar 26, 2007

Last updated

Jul 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Stephen D. Hobby DMD PC

  • Dentist
  • Ocilla, GA
  • NPI 1023289287
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1215054051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2569",
            "city": "ASHBURN",
            "state": "GA",
            "postal_code": "317142569",
            "telephone_number": "229-326-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E COLLEGE AVE",
            "city": "ASHBURN",
            "state": "GA",
            "postal_code": "317145209",
            "telephone_number": "229-326-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBBY",
        "first_name": "WALLIS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "101078",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9183415",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "852444578A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daryl Hall
• Wendy M Hancock, RDH
• Mariel Danita Hepburn
• Montakesha Range Hillmon
• Mary Grace Hobby I, CCC-SLP
• Kathy McLeod (R & M Cash Drugs)
• Patrina Lockette, M.D.
• Earl A Lorenzen, M.D.
• Middle Creek Management (Ashburn Family Pharmacy)
• Engra De'Ete Moore, BA, MS

• General Practice Dentistry in Ashburn, GA
• Providers in Ashburn, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.