Macon Ga Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

MACON GA ORTHODONTICS

Practice address

3312 Northside Dr
Building B # 150
Macon, GA 31210-2500

Phone

(478) 746-7686

Fax

(478) 254-3870

NPI assigned

Feb 2, 2015

Last updated

Feb 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Brenda Holland Oliver

Title

Practice Administrator

Phone

(478) 746-7686

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1649660473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 NORTHSIDE DR",
            "address_2": "BUILDING B # 150",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102500",
            "telephone_number": "478-746-7686",
            "fax_number": "478-254-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 NORTHSIDE DR",
            "address_2": "BUILDING B # 150",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102500",
            "telephone_number": "478-746-7686",
            "fax_number": "478-254-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACON GA ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "HOLLAND",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "478-746-7686",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macon Dentist Office, PC (Macon Dentist Office)
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• Macon Gynecologic Oncology LLC
• Macon Healthcare LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Macon, GA
• Providers in Macon, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.