NPIMap

Organization Active NPI

Claxton Family Dentistry LLC

Doing business as Reidsville Family Dentistry

  • Dentist
  • Reidsville, GA
National Provider Identifier
1669024824
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CLAXTON FAMILY DENTISTRY LLC
Doing business as
Reidsville Family Dentistry
Practice address
244 S Main Street
Reidsville, GA 30453-3045
Phone
(912) 557-6307
NPI assigned
Jul 9, 2019
Last updated
Jul 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Authorized official

Name
Zackary L. Bentley
Title
Owner
Phone
(912) 557-6307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

244 S Main Street
Reidsville, GA 30453-3045

Mailing address

PO Box 669
Reidsville, GA 30453-0669

Other names 1

  • Reidsville Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Claxton Family Dentistry LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1562630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1669024824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669",
            "city": "REIDSVILLE",
            "state": "GA",
            "postal_code": "304530669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 S MAIN STREET",
            "city": "REIDSVILLE",
            "state": "GA",
            "postal_code": "304533045",
            "telephone_number": "912-557-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAXTON FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "ZACKARY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-557-6307"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reidsville Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reidsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.