Active NPI
Steven R Echols, DMD
- Dentist
- Augusta, GA
National Provider Identifier
1417935545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- GA DN009155
- Practice address
- 2467 Golden Camp Rd
Augusta, GA 30906-5515 - Phone
- (706) 790-4440
- NPI assigned
- Jan 9, 2006
- Sex
- Male
- Sole proprietor
- No
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 | GA DN009155 | GA | Primary |
Addresses
Primary practice location
2467 Golden Camp Rd
Augusta, GA 30906-5515
Mailing address
4913 Five Points Jewell Rd
Mitchell, GA 30820-7905
Phone (706) 465-0315
Other practice location 1
1816 Lakefield Ct SE
Conyers, GA 30013-6609
Phone (770) 860-8760
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600198624I | Medicaid | GA |
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 |
|---|---|---|---|
| GA DN009155 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smile Dental Group of Conyers PC | 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.
-
- Dental Clinic/Center
- Conyers, GA
- NPI 1235117375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736985600000",
"number": "1417935545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4913 FIVE POINTS JEWELL RD",
"city": "MITCHELL",
"state": "GA",
"postal_code": "308207905",
"telephone_number": "706-465-0315",
"fax_number": "706-864-0315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2467 GOLDEN CAMP RD",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309065515",
"telephone_number": "706-790-4440"
}
],
"practiceLocations": [
{
"address_1": "1816 Lakefield Ct SE",
"address_purpose": "LOCATION",
"city": "Conyers",
"state": "GA",
"postal_code": "300136609",
"country_code": "US",
"telephone_number": "770-860-8760",
"fax_number": "678-413-8144",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ECHOLS",
"first_name": "STEVEN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-09",
"last_updated": "2025-01-16",
"certification_date": "2025-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "GA DN009155",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "600198624I",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.