NPIMap

Organization Active NPI

Lifetime Dentistry

  • General Practice Dentistry
  • Suwanee, GA
National Provider Identifier
1376930644
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN01285 Issued in GA
Legal business name
LIFETIME DENTISTRY
Practice address
3921 Johns Creek CT
Suite a
Suwanee, GA 30024-1219
Phone
(770) 674-0226
Fax
(770) 807-1671
NPI assigned
Apr 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Authorized official

Name
Ms. Donna Phillips, RDH
Title
Practice Manager
Phone
(770) 674-0226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN01285 GA Primary

Addresses

Primary practice location

3921 Johns Creek CT
Suite a
Suwanee, GA 30024-1219

Mailing address

3921 Johns Creek CT
Suite a
Suwanee, GA 30024-1219
Phone (770) 674-0226

Other names 1

  • Lifetime Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

3921 Johns Creek Ct
Ste A
Suwanee, GA 30024
Phone (678) 990-5980

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1376930644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 JOHNS CREEK CT",
            "address_2": "SUITE A",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241219",
            "telephone_number": "770-674-0226",
            "fax_number": "770-807-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 JOHNS CREEK CT",
            "address_2": "SUITE A",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241219",
            "telephone_number": "770-674-0226",
            "fax_number": "770-807-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "770-674-0226",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN01285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.