Rehoboth Life Care Ministries, Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

REHOBOTH LIFE CARE MINISTRIES, INC

Practice address

3208 Hwy 41
Byron
Byron, GA 31008

Phone

(478) 953-7770

Fax

(478) 953-7771

NPI assigned

Oct 9, 2019

Organization subpart

No

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

Authorized official

Name

Teresa Hodges

Title

Clinic Director

Phone

(478) 953-7770

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1255973566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3208 HWY 41",
            "address_2": "BYRON",
            "city": "BYRON",
            "state": "GA",
            "postal_code": "31008",
            "telephone_number": "478-953-7770",
            "fax_number": "478-953-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 HWY 41",
            "address_2": "BYRON",
            "city": "BYRON",
            "state": "GA",
            "postal_code": "31008",
            "telephone_number": "478-953-7770",
            "fax_number": "478-953-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHOBOTH LIFE CARE MINISTRIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "478-953-7770"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Byron, GA
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• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.