Individual provider Active NPI

Abby Lee Raymond, DDS

  • Dentist
  • Fort Benning, GA
National Provider Identifier
1700136959
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
80814689921 Issued in UT
Practice address
7101 Hoff St
Fort Benning, GA 31905-5645
Phone
(706) 544-4530
Fax
(706) 544-1933
NPI assigned
Sep 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 80814689921 UT Primary

Addresses

Primary practice location

7101 Hoff St
Fort Benning, GA 31905-5645

Mailing address

7101 Hoff St
Fort Benning, GA 31905-5645
Phone (706) 544-4530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
80814689921UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Raymond Cosmetic & Implant Dentistry CurrentSince Oct 8, 2023 Accepting new patients

Locations

1251 Wesley Dr
Ste 130
Memphis, TN 38116
Phone (901) 332-9170

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1700136959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 HOFF ST",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319055645",
            "telephone_number": "706-544-4530",
            "fax_number": "706-544-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 HOFF ST",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319055645",
            "telephone_number": "706-544-4530",
            "fax_number": "706-544-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "ABBY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-14",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "80814689921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Benning, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.