Active NPI
Stan Lawrence Rentz, D.M.D.
- Dentist
- Georgetown, GA
National Provider Identifier
1417119470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN013769
- Practice address
- 41 Old School Rd
Georgetown, GA 39854-4627 - Phone
- (229) 334-5515
- NPI assigned
- Jun 30, 2008
- Last updated
- Jun 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN013769 | GA | Primary |
Addresses
Primary practice location
41 Old School Rd
Georgetown, GA 39854-4627
Mailing address
111 E Gordon St
Valdosta, GA 31601-4554
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN013769 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214784000000",
"number": "1417119470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E GORDON ST",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316014554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 OLD SCHOOL RD",
"city": "GEORGETOWN",
"state": "GA",
"postal_code": "398544627",
"telephone_number": "229-334-5515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENTZ",
"first_name": "STAN",
"middle_name": "LAWRENCE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-30",
"last_updated": "2008-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN013769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.