G. Michael Wommack, DMD, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012803 Issued in GA

Legal business name

G. MICHAEL WOMMACK, DMD, PC

Doing business as

Wommack Dentistry

Practice address

2900 Glynn Ave
Brunswick, GA 31520-4844

Phone

(912) 342-7049

Fax

(912) 342-7942

NPI assigned

May 19, 2011

Last updated

May 19, 2011By 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. George Michael Wommack, D.M.D.NPI 1437364338

Title

Owner

Phone

(912) 342-7049

Specialties & licenses 1

Addresses

Other names 1

• Wommack Dentistry Doing business as

Locations

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.

• George Michael Wommack, D.M.D.

  • General Practice Dentistry
  • Brunswick, GA
  • NPI 1437364338
  NPD (past) Authorized official

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1760775043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204844",
            "telephone_number": "912-342-7049",
            "fax_number": "912-342-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204844",
            "telephone_number": "912-342-7049",
            "fax_number": "912-342-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G. MICHAEL WOMMACK, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "WOMMACK",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-342-7049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wommack Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric William Friedrich II
• Amelia Harper Fritchman, MED CCC-SLP
• Adriana Fuel, IBCLC
• Nicole Shupe Fullard, NP
• Linda Sue Fuller, LCMHC
• Emmanuel Gage
• Mary Teresa Gainey, RBT
• Brittani M Garner, LPN
• Gary M. Grolemund DPM
• Gary M. Grolemund, DPM PC

• General Practice Dentistry in Brunswick, GA
• Providers in Brunswick, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.