Individual provider Active NPI

Madelyn Herrington Newman, DMD

  • General Practice Dentistry
  • Pooler, GA
National Provider Identifier
1609764166
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN123797 Issued in GA
Practice address
125 Southern Junction Blvd Ste 701
Pooler, GA 31322-2216
Phone
(912) 330-4545
NPI assigned
Jun 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN123797 GA Primary

Addresses

Primary practice location

125 Southern Junction Blvd Ste 701
Pooler, GA 31322-2216

Mailing address

125 Southern Junction Blvd Ste 701
Pooler, GA 31322-2216
Phone (912) 253-7931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN123797GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Dental Wellness LLC General Practice CurrentSince Jun 29, 2025 Accepting new patients
Towne Lake Dental Group, LLC General Practice Past Accepting new patients

Locations

1130 Brampton Ave
Statesboro, GA 30458
Phone (912) 764-3724

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1609764166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SOUTHERN JUNCTION BLVD STE 701",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222216",
            "telephone_number": "912-253-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SOUTHERN JUNCTION BLVD STE 701",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222216",
            "telephone_number": "912-330-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "MADELYN",
        "middle_name": "HERRINGTON",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-25",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.