Organization Active NPI

Lanier Orthodontics PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Gainesville, GA
National Provider Identifier
1508954116
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN011067 Issued in GA
Legal business name
LANIER ORTHODONTICS PA
Practice address
1215 Sherwood Park Dr NE
Gainesville, GA 30501-3444
Phone
(770) 532-4156
Fax
(770) 536-1529
NPI assigned
Oct 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kym Maddox
Title
Corporate Secretary
Phone
(770) 532-8104

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X DN011067 GA Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X DN011899 GA

Addresses

Primary practice location

1215 Sherwood Park Dr NE
Gainesville, GA 30501-3444

Mailing address

1215 Sherwood Park Dr NE
Gainesville, GA 30501-3444
Phone (770) 532-4156

National Provider Directory

National Provider Directory

Locations

1215 Sherwood Park Dr NE
Gainesville, GA 30501
Phone (770) 532-4156

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": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508954116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 SHERWOOD PARK DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013444",
            "telephone_number": "770-532-4156",
            "fax_number": "770-536-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 SHERWOOD PARK DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013444",
            "telephone_number": "770-532-4156",
            "fax_number": "770-536-1529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANIER ORTHODONTICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "KYM",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "770-532-8104"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN011067",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN011899",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.