Dental Wellness Center of Macon, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL WELLNESS CENTER OF MACON, LLC

Practice address

236 Tom Hill Sr Blvd Unit 9
Macon, GA 31210-1815

Phone

(888) 885-8492

Fax

(912) 226-3489

NPI assigned

Mar 8, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Christie D Lawrence

Title

Corporate Operations Coordinator

Phone

(912) 920-5577

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1639637622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60339",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314200339",
            "telephone_number": "912-920-5577",
            "fax_number": "912-226-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 TOM HILL SR BLVD UNIT 9",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101815",
            "telephone_number": "888-885-8492",
            "fax_number": "912-226-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL WELLNESS CENTER OF MACON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-08",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CORPORATE OPERATIONS COORDINATOR",
        "authorized_official_telephone_number": "912-920-5577",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DN010747",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497918759",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Taylor Denny, M.D.
• Marsha Thorn Denny, FNP
• Ashley Dent
• Dental Care Center of Macon, PC
• Dental Sleep Therapy of Macon LLC
• Derrick Lane, MD, LLC
• Judith Loudon Derriso, LCSW
• Jaimin Desai, DMD
• Niraj Desai, MD
• Developing Minds Treatment Center, LLC

• Dental Clinic/Center in Macon, GA
• Providers in Macon, 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 Jun 11, 2019; 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.