Individual provider Active NPI

Dwight O McLaurin, D.D.S.

  • General Practice Dentistry
  • Columbus, GA
National Provider Identifier
1225122005
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7765 Issued in GA
Practice address
2200 Rosemont Dr
Columbus, GA 31904-7369
Phone
(706) 596-1895
Fax
(706) 596-1030
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7765 GA Primary

Addresses

Primary practice location

2200 Rosemont Dr
Columbus, GA 31904-7369

Mailing address

2200 Rosemont Dr
Columbus, GA 31904-7369
Phone (706) 596-1895

Other identifiers 1

IdentifierTypeStateIssuer
00050278MedicaidGA

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
I20150702000704 GA Order and Referring Only - DentistPractitioner - Dentist 2769794882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7765GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McLaurin and McLaurin, DDS, PC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225122005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 ROSEMONT DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319047369",
            "telephone_number": "706-596-1895",
            "fax_number": "706-596-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 ROSEMONT DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319047369",
            "telephone_number": "706-596-1895",
            "fax_number": "706-596-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAURIN",
        "first_name": "DWIGHT",
        "middle_name": "O",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "7765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00050278",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.