Sweetgums Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DN013438 Issued in GA

Legal business name

SWEETGUMS DENTAL LLC

Practice address

1435 54TH St
Suite 100a
Columbus, GA 31904-4998

Phone

(706) 507-9132

Fax

(706) 507-9135

NPI assigned

Feb 10, 2011

Organization subpart

No

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

Authorized official

Name

Laretha Urett Lockhart, DDS

Title

Owner/Dentist

Phone

(706) 507-9132

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297296000000",
    "number": "1477859387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 54TH ST",
            "address_2": "SUITE 100A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044998",
            "telephone_number": "706-507-9132",
            "fax_number": "706-507-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 54TH ST",
            "address_2": "SUITE 100A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044998",
            "telephone_number": "706-507-9132",
            "fax_number": "706-507-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEETGUMS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2011-02-10",
        "status": "A",
        "authorized_official_last_name": "LOCKHART",
        "authorized_official_first_name": "LARETHA",
        "authorized_official_middle_name": "URETT",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "706-507-9132",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "355358613B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Banowsky Swain
• Jada Swanson, NP
• Kimberly Williams Swanson, LMT
• Merle Ray Swartzentruber, DMD
• Sweet Home Care of Georgia Inc (Acti-Kare Responsive in-Home Care)
• Danielle Swenson
• Mary Lou Swift, LPC
• Virginia Schorr Swinehart
• Jamie Marie Swint
• Katelyn Switzer, NP

• Dentist in Columbus, GA
• Providers in Columbus, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; 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.