Legacy Family Dentistry, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LEGACY FAMILY DENTISTRY, P.C.

Practice address

224 Shallowford Rd NW
Gainesville, GA 30504-4171

Phone

(770) 536-1170

NPI assigned

Feb 9, 2024

Last updated

Feb 9, 2024By 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

Ben Cutler

Title

Secretary

Phone

(607) 743-9474

Specialties & licenses 3

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Henry Grady Goble, D.D.S.

  • General Practice Dentistry
  • Gainesville, GA
  • NPI 1770669632
  NPD (past)
• Mary Kristin Jorgensen, DDS

  • Dentist
  • Gainesville, GA
  • NPI 1821091521
  NPD (past)

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1356105423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 SHALLOWFORD RD NW",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305044171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 SHALLOWFORD RD NW",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305044171",
            "telephone_number": "770-536-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY FAMILY DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "CUTLER",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "607-743-9474"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yong Wan Lee, MD
• Christopher Lee Leech, ACNP-BC
• Jacob Leedekerken
• Ryan Leeson, MD
• Heneicia Leflore, PA-C
• Legacy Healthcare Services Inc
• Legacy Heart Care of Gainesville, LLC
• Legacy Link, Inc
• Molly Legg, PT
• Jason Aaron Lemons, M.D.

• General Practice Dentistry in Gainesville, GA
• Providers in Gainesville, 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 Feb 9, 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.