Roberto Lara, DMD

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

DN122646 Issued in GA

Practice address

106 Shoppers Way Ste 108
Brunswick, GA 31525-0522

Phone

(912) 342-7622

NPI assigned

May 24, 2022

Last updated

May 24, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: roberto.lara@cchs.gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coastal Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Brunswick, GA
  • NPI 1609298751
  NPD

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1497493084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 SHOPPERS WAY STE 108",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250522",
            "telephone_number": "912-342-7622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SHOPPERS WAY STE 108",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250522",
            "telephone_number": "912-342-7622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "GA",
            "license": "DN122646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Alexis Langford
• Christina Renee Langley
• Joseph Anthony Lanzone Jr., M.D.
• Rebecca Dawn Lapham, D.C.
• William D. Lapierre, L.C.S.W.
• Rebekah Elizabeth Larkey, PHARMD.
• Elizabeth G Laroche, BEHAVIOR
• Rebekah Laroche
• Angela S Latham, PA-C
• Cassandra Coe Latham, N.P.

• Public Health Dentistry in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Public Health Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.