Southern Smiles Lawrenceville PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTHERN SMILES LAWRENCEVILLE PC

Practice address

2401 Lawrenceville Hwy Ste a
Lawrenceville, GA 30044-4669

Phone

(678) 909-1970

NPI assigned

Feb 10, 2022

Last updated

Feb 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin H Adler

Title

Partner

Phone

(404) 784-8659

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1275287088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 LAWRENCEVILLE HWY STE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 LAWRENCEVILLE HWY STE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444669",
            "telephone_number": "678-909-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SMILES LAWRENCEVILLE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "ADLER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "404-784-8659"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Lawrenceville, GA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.