NPIMap

Organization Active NPI

Lagrange Family Dental Center

Doing business as George W Baker Jr

  • Dentist
  • Lagrange, GA
National Provider Identifier
1487807434
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8745 Issued in GA
Legal business name
LAGRANGE FAMILY DENTAL CENTER
Doing business as
George W Baker Jr
Practice address
606 S Greenwood St
Lagrange, GA 30240-3128
Phone
(706) 882-5551
Fax
(706) 812-8558
NPI assigned
Nov 3, 2008
Last updated
Dec 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Authorized official

Name
Mr. George W Baker Jr., D.M.DNPI 1669413993
Title
Owner
Phone
(706) 882-5551

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
Dentist 122300000X 8745 GA Primary

Addresses

Primary practice location

606 S Greenwood St
Lagrange, GA 30240-3128

Mailing address

PO Box 2030
Lagrange, GA 30241-0042
Phone (706) 882-5551

Other identifiers 2

IdentifierTypeStateIssuer
1386680734MedicaidGA
1669413993MedicaidGA

Other names 1

  • George W Baker Jr Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325030400000",
    "number": "1487807434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2030",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302410042",
            "telephone_number": "706-882-5551",
            "fax_number": "706-812-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 S GREENWOOD ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403128",
            "telephone_number": "706-882-5551",
            "fax_number": "706-812-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGRANGE FAMILY DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-03",
        "last_updated": "2011-12-28",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-882-5551",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "8745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386680734",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669413993",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "George W Baker Jr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.