Individual provider Active NPI

Crystal Sorg

  • General Practice Dentistry
  • Claxton, GA
National Provider Identifier
1497546162
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN124156 Issued in GA
Practice address
201 E Long St
Claxton, GA 30417-1409
Phone
(912) 739-1595
NPI assigned
May 13, 2025
Sex
Female
Sole proprietor
No

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.

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

LicenseStateTypeSpecialty
DN124156GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Claxton Family Dentistry LLC Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN124156 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

201 E Long St
Claxton, GA 30417-1409

Mailing address

201 E Long St
Claxton, GA 30417-1409

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 29, 2026.

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1497546162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E LONG ST",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304171409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E LONG ST",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304171409",
            "telephone_number": "912-739-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORG",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-13",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN124156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claxton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.