Crystal Sorg

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

Last updated

May 29, 2026By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Claxton Family Dentistry LLC

  • Dentist
  • Claxton, GA
  • NPI 1073963476
  NPD (past)

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

{
    "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": []
}

• Premise Health of Georgia Medical PC (Claxton Poultry Wellness Center)
• Lutrenda Renelus
• Lafils Ann Rivers
• Jesse B Scott, MD
• Ronald Douglas Smith, RPH
• Southeast Lung & Critical Care Specialists, PC (Southeast Lung Associates)
• Southeast Lung and Critical Care Specialist (Southeast Lung Associates)
• Southern Medical Group
• Southland Evans Emergency Medical Services LLC
• Southland Evans Hospitalist Group LLC

• General Practice Dentistry in Claxton, GA
• Providers in Claxton, GA by specialty
• General Practice Dentistry in Georgia

• 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.