Individual provider Active NPI

Joe Nathan Lester, DDS

  • General Practice Dentistry
  • Conyers, GA
National Provider Identifier
1356421630
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9947 Issued in GA
Practice address
1217 Royal Dr SW
Conyers, GA 30094-5967
Phone
(770) 922-6655
Fax
(770) 388-0521
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9947 GA Primary

Addresses

Primary practice location

1217 Royal Dr SW
Conyers, GA 30094-5967

Mailing address

1217 Royal Dr SW
Conyers, GA 30094-5967
Phone (770) 922-6655

Other identifiers 1

IdentifierTypeStateIssuer
000287955HMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lester Dental Group LLC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356421630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 ROYAL DR SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945967",
            "telephone_number": "770-922-6655",
            "fax_number": "770-388-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 ROYAL DR SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945967",
            "telephone_number": "770-922-6655",
            "fax_number": "770-388-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESTER",
        "first_name": "JOE",
        "middle_name": "NATHAN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000287955H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.