NPIMap

Organization Active NPI

Lester Dental Group LLC

  • General Practice Dentistry
  • Conyers, GA
National Provider Identifier
1659440311
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN009947 Issued in GA
Legal business name
LESTER DENTAL GROUP LLC
Practice address
1217 Royal Dr SW
Conyers, GA 30094-5967
Phone
(770) 922-6655
Fax
(770) 388-0521
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Authorized official

Name
Dr. Joe N Lester, DDSNPI 1356421630
Title
Owner
Phone
(770) 922-6655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DN009947 GA Primary

Addresses

Primary practice location

1217 Royal Dr SW
Conyers, GA 30094-5967

Mailing address

1217 Royal Dr SW
Conyers, GA 30094-5967
Phone (770) 922-6655

Other identifiers 4

IdentifierTypeStateIssuer
801628040CMedicaidGA
039132651AMedicaidGA
000287955HMedicaidGA
000900974AMedicaidGA

Other names 1

  • Joe N Lester DDS Former legal business name

National Provider Directory

National Provider Directory

Locations

1217 Royal Dr SW
Conyers, GA 30094
Phone (770) 922-6655

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1659440311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 ROYAL DR SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945967",
            "telephone_number": "770-922-6655",
            "fax_number": "770-388-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 ROYAL DR SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945967",
            "telephone_number": "770-922-6655",
            "fax_number": "770-388-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESTER DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "LESTER",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-922-6655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN009947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "801628040C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039132651A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000287955H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000900974A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joe N Lester DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.