Individual provider Active NPI

Jazmyn Elizabeth Laing, DDS

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1275126443
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN122632 Issued in GA
Practice address
1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318-6653
Phone
(404) 523-6571
NPI assigned
Feb 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X DN122632 GA Primary

Addresses

Primary practice location

1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318-6653

Mailing address

2830 Colony CV
Southaven, MS 38672-5003
Phone (214) 453-9489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20260507000437 TN Practitioner - Dentist 4385124247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Meharry Medical College School of Dentistry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1200 Synergy Way
Holly Hill, FL 32117-2502

2670 Union Ave Ext
Suite 1000
Memphis, TN 38112-4416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN122632GAMDGeneral Practice Dentistry
13030TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Good Samaritan Health Center, Inc. CurrentSince Feb 21, 2021 Accepting new patients
Hope First Investments CurrentSince Sep 20, 2022 Accepting new patients
Peachtree Smiles II PC Past Accepting new patients

Locations

1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318
Phone (404) 523-6571

Organizations & group practices 4

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": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1275126443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 COLONY CV",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386725003",
            "telephone_number": "214-453-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 DONALD LEE HOLLOWELL PKWY NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303186653",
            "telephone_number": "404-523-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAING",
        "first_name": "JAZMYN",
        "middle_name": "ELIZABETH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-18",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.