Lilburn Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012698 Issued in GA

Legal business name

LILBURN DENTAL CENTER

Practice address

4145 Lawrenceville Hwy NW
Ste 5
Lilburn, GA 30047-2807

Phone

(770) 638-8090

Fax

(770) 638-8144

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Erica Ewomack

Title

Office Mangager

Phone

(770) 638-8090

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1285770701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4145 LAWRENCEVILLE HWY NW",
            "address_2": "STE 5",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472807",
            "telephone_number": "770-638-8090",
            "fax_number": "770-638-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4145 LAWRENCEVILLE HWY NW",
            "address_2": "STE 5",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472807",
            "telephone_number": "770-638-8090",
            "fax_number": "770-638-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILBURN DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "EWOMACK",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "OFFICE MANGAGER",
        "authorized_official_telephone_number": "770-638-8090"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifeline Medical Center, LLC
• Lifeline Primary Care, Inc
• Gwendolyn Ann Ligon, MS
• Lilburn Acupuncture LLC
• Lilburn Community Pharmacy
• Lilburn Dental Group, L.L.C.
• Lilburn Dental Studio
• Lilburn Dentistry Group, LLC
• Lilburn Medical Center PC
• Lilburn Pediatrics

• General Practice Dentistry in Lilburn, GA
• Providers in Lilburn, 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 Aug 13, 2008; 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.