Magnolia Roots Endodontics LLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

MAGNOLIA ROOTS ENDODONTICS LLC

Practice address

100 Blue Moon Xing Ste 103
Pooler, GA 31322-9809

Phone

(239) 404-0691

NPI assigned

May 16, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Carleen Burt Sells, DMDNPI 1770920910

Title

Owner

Phone

(912) 737-4044

Specialties & licenses 1

Addresses

Practitioners 1

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

• Carleen Burt Sells, D.M.D.

  • Endodontics
  • Pooler, GA
  • NPI 1770920910
  NPD Authorized official

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729987200000",
    "number": "1598514960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 OAKDENE RD",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313229783",
            "telephone_number": "239-404-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BLUE MOON XING STE 103",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313229809",
            "telephone_number": "239-404-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA ROOTS ENDODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-10-27",
        "certification_date": "2024-10-27",
        "status": "A",
        "authorized_official_last_name": "SELLS",
        "authorized_official_first_name": "CARLEEN",
        "authorized_official_middle_name": "BURT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-737-4044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyanna Rose Lucero, RBT
• Tea M Lungarini
• Courtney Ann Luukko
• Hung Thien Ly, M.D.
• Christina Macropoulos Berry, PT, DPT
• Rolando Manalo, MD
• Mark Lynn O.D. & Associates, P.C.
• Kristy Harden Maronie, PHARMACIST
• Chaunta Denise Martin
• Lindsay Martin

• Endodontics in Pooler, GA
• Providers in Pooler, GA by specialty
• Endodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2024; 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.