NPIMap

Organization Active NPI

Lana L. Mamut, DMD, PC

  • Dental Clinic/Center
  • Suwanee, GA
National Provider Identifier
1437487550
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN012943 Issued in GA
Legal business name
LANA L. MAMUT, DMD, PC
Practice address
3130 Mathis Airport Pkwy
Ste 309
Suwanee, GA 30024-9131
Phone
(404) 579-0519
NPI assigned
Dec 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Authorized official

Name
Dr. Lana Lvovna Mamut, DMDNPI 1578731907
Title
Owner Dentist
Phone
(404) 579-0519

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN012943 GA Primary

Addresses

Primary practice location

3130 Mathis Airport Pkwy
Ste 309
Suwanee, GA 30024-9131

Mailing address

3130 Mathis Airport Pkwy
Ste 309
Suwanee, GA 30024-9131
Phone (404) 579-0519

Other names 1

  • Family Dentistry of Forsyth Doing business as

National Provider Directory

National Provider Directory

Locations

3130 Mathis Airport Pkwy
Ste 309
Suwanee, GA 30024
Phone (404) 579-0519

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1437487550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 MATHIS AIRPORT PKWY",
            "address_2": "STE 309",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249131",
            "telephone_number": "404-579-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 MATHIS AIRPORT PKWY",
            "address_2": "STE 309",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249131",
            "telephone_number": "404-579-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANA L. MAMUT, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-01",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "MAMUT",
        "authorized_official_first_name": "LANA",
        "authorized_official_middle_name": "LVOVNA",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "404-579-0519",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DN012943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dentistry of Forsyth",
            "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 Jul 29, 2013; 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.