NPIMap

Organization Active NPI

Golden Isles Endodontics, LLC

  • Endodontics
  • Saint Simons Island, GA
National Provider Identifier
1710382007
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN013079 Issued in GA
Legal business name
GOLDEN ISLES ENDODONTICS, LLC
Practice address
1804 Frederica Rd Ste B
Saint Simons Island, GA 31522-2044
Phone
(912) 268-2800
Fax
(912) 434-9936
NPI assigned
Oct 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Authorized official

Name
Christopher Lea, DDSNPI 1295783298
Title
Owner
Phone
(912) 756-5960

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
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X DN013079 GA Primary

Addresses

Primary practice location

1804 Frederica Rd Ste B
Saint Simons Island, GA 31522-2044

Mailing address

PO Box 20067
Saint Simons Island, GA 31522-8067
Phone (912) 268-2800

Other names 1

  • Coastal Endodontics Doing business as

National Provider Directory

National Provider Directory

Locations

1804 Frederica Rd
Ste B
St Simons Island, GA 31522
Phone (912) 268-2800

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": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1710382007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20067",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315228067",
            "telephone_number": "912-268-2800",
            "fax_number": "912-434-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 FREDERICA RD STE B",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222044",
            "telephone_number": "912-268-2800",
            "fax_number": "912-434-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN ISLES ENDODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "LEA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-756-5960",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "DN013079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Simons Island, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.