Countryside Dental - Lagrange

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

COUNTRYSIDE DENTAL - LAGRANGE

Doing business as

Countryside Dental & Aesthetics

Practice address

307 Church St FL 1
Lagrange, GA 30240-2700

Phone

(706) 884-3263

Fax

(706) 884-3263

NPI assigned

Nov 29, 2025

Organization subpart

No

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

Authorized official

Name

Yokeca Nicole Watts, DMDNPI 1003350059

Title

Dentist, Partner

Phone

(205) 563-9877

Specialties & licenses 1

Addresses

Other names 1

• Countryside Dental & Aesthetics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yokeca Nicole Watts, D.M.D.

  • General Practice Dentistry
  • Powder Springs, GA
  • NPI 1003350059
  NPD Authorized official

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

{
    "created_epoch": "1764374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764374400000",
    "number": "1558223461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 CHURCH ST FL 1",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402700",
            "telephone_number": "706-884-3263",
            "fax_number": "706-884-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 CHURCH ST FL 1",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402700",
            "telephone_number": "706-884-3263",
            "fax_number": "706-884-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE DENTAL - LAGRANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-29",
        "last_updated": "2025-11-29",
        "certification_date": "2025-11-29",
        "status": "A",
        "authorized_official_last_name": "WATTS",
        "authorized_official_first_name": "YOKECA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "DENTIST, PARTNER",
        "authorized_official_telephone_number": "205-563-9877",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Countryside Dental & Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephani Lee Cornelison, PHD, LCSW
• Steven B. Cosper I, D.C
• Serena M Coulombe, CRNP
• Darrin Coulter, PA
• Counseling Services of Lagrange, Inc.
• Countryside Hospice Care, Inc
• Covenant Counsel, LLC
• Rebecca Noel Covin, BS, RBT
• Shanterrika L Cox
• Kylia Butler Crane, RD, LD

• Dental Clinic/Center in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2025; 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.