Alexis Lauren Willis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN123542 Issued in GA

Practice address

718 N Broad St
Cairo, GA 39828-1607

Phone

(229) 377-4204

NPI assigned

Aug 1, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Jennifer W. Kendrick DMD, LLC

  • General Practice Physician
  • Cairo, GA
  • NPI 1124845730
  NPD
• Dental Associates of Southwest Georgia, LLC

  • General Practice Dentistry
  • Cairo, GA
  • NPI 1104843861
  NPD (past)

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1295564656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 N BROAD ST",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398281607",
            "telephone_number": "229-377-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 N BROAD ST",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398281607",
            "telephone_number": "229-377-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ALEXIS",
        "middle_name": "LAUREN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN123542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Weaver Medical Center, LLC
• Wellness Life Center LLC
• Wendy Wheeler, RRT, RCP
• Conner White
• Beverlee M Wilder, PT
• Frances M. Youmans, N.P.
• Young at Heart Healthcare Services, LLC
• Your Medical Labs and More Inc

• All providers in Cairo, GA
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.