NPIMap

Organization Active NPI

Towne Lake Family Dentistry, LTD.

  • General Practice Dentistry
  • Woodstock, GA
National Provider Identifier
1629380191
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10504 Issued in GA
Legal business name
TOWNE LAKE FAMILY DENTISTRY, LTD.
Practice address
120 N Medical Pkwy
BLDG 200, Ste 100
Woodstock, GA 30189-7062
Phone
(770) 591-7929
NPI assigned
Jul 13, 2010
Last updated
Jul 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Authorized official

Name
Dr. Ray Morgan Jr., D.M.D.NPI 1649317033
Title
Owner
Phone
(770) 591-7929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 10504 GA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 014049 GA
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 011800 GA

Addresses

Primary practice location

120 N Medical Pkwy
BLDG 200, Ste 100
Woodstock, GA 30189-7062

Mailing address

120 N Medical Pkwy
BLDG 200, Ste 100
Woodstock, GA 30189-7062
Phone (770) 591-7929

National Provider Directory

National Provider Directory

Locations

120 N Medical Pkwy
Bldg 200
Woodstock, GA 30189
Phone (770) 591-7929

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": "1278979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278979200000",
    "number": "1629380191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N MEDICAL PKWY",
            "address_2": "BLDG 200, STE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897062",
            "telephone_number": "770-591-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N MEDICAL PKWY",
            "address_2": "BLDG 200, STE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897062",
            "telephone_number": "770-591-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWNE LAKE FAMILY DENTISTRY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-13",
        "last_updated": "2010-07-13",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-591-7929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10504",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "014049",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "011800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.