Southern Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

11208 Issued in GA

Legal business name

SOUTHERN ORTHODONTICS

Practice address

12 Long Leaf Office Park
Moultrie, GA 31768-6780

Phone

(229) 985-4715

Fax

(229) 985-0997

NPI assigned

May 7, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

J Gregory Morris, D.M.D.

Title

President

Phone

(229) 985-4715

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548473754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 LONG LEAF OFFICE PARK",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686780",
            "telephone_number": "229-985-4715",
            "fax_number": "229-985-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 LONG LEAF OFFICE PARK",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686780",
            "telephone_number": "229-985-4715",
            "fax_number": "229-985-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-985-4715",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "11208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "11208",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Ga Gastroenterology & Nutrition Support, Inc.
• South Ga Spine Care Institute
• South Georgia Clinic of Chiropractic Medicine (Sircy Chiropractic Clinic)
• South Georgia Pharmacy Services Inc (Convenient RX LTC #2)
• Southeastern Urogynecology & Pelvic Surgery LLC (Sterling Group Urogynecology & Pelvic Surgery)
• Southern Pelvic Therapy LLC
• Southwestern State Hospital (Assertive Community Treatment Program)
• Jordan Sparks, PA-C
• Special Healthcare Solutions
• Robert O Spruill, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Moultrie, GA
• Providers in Moultrie, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• 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.