Lauren Lee Polito, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

DN014262 Issued in GA

Practice address

1233 Highway 54 W Ste 100
Fayetteville, GA 30214-4542

Phone

(770) 461-6465

Fax

(770) 461-2888

NPI assigned

Oct 14, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sparkling Smiles Fayetteville LLC

  • Dentist
  • Fayetteville, GA
  • NPI 1508549932
  NPD

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1770868382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 HIGHWAY 54 W STE 100",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144542",
            "telephone_number": "770-461-6465",
            "fax_number": "770-461-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 HIGHWAY 54 W STE 100",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144542",
            "telephone_number": "770-461-6465",
            "fax_number": "770-461-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITO",
        "first_name": "LAUREN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-14",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202137",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4474",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emile C Pinera, M.D.
• Platinum Healthcare Services
• Platinum Pharmacy LLC (Platinum Pharmacy)
• Plattaz Dialysis, LLC (West Clayton Dialysis)
• Elisabeth Pleasant
• Yolanda Polk
• Arvind Jayaraj Ponnambalam, MD
• David Michael Popoli, M.D.
• Scharmane Porter
• Tiffany Porter

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.