Jimmy F Maxwell DMD PC

Primary specialty

DentistTaxonomy code 122300000X

License

DN009648 Issued in GA

Legal business name

JIMMY F MAXWELL DMD PC

Practice address

500 Amelia Avenue
Bainbridge, GA 39818-0727

Phone

(229) 246-3023

Fax

(229) 246-3024

NPI assigned

Apr 19, 2006

Last updated

Sep 26, 2012By 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

Dr. Jimmy Foster Maxwell, DMD PCNPI 1033433610

Title

Owner Dentist

Phone

(229) 246-3023

Specialties & licenses 3

Addresses

Other identifiers 2

Practitioners 1

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.

• Jimmy Foster Maxwell, D.M.D., P.C.

  • Dentist
  • Bainbridge, GA
  • NPI 1033433610
  Authorized official Same address or phone

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348617600000",
    "number": "1750346102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "address_2": "500 AMELIA AVENUE",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398180727",
            "telephone_number": "229-246-3023",
            "fax_number": "229-246-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 AMELIA AVENUE",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398180727",
            "telephone_number": "229-246-3023",
            "fax_number": "229-246-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMMY F MAXWELL DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2012-09-26",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "FOSTER",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "229-246-3023",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD PC"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN009648",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN9728",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS0000007704",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA BOARD OF PHARMACY",
            "identifier": "RPHO11407",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00245341A4",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Bainbridge, GA
• Providers in Bainbridge, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.