Ingleside Dental Assoicates, P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

0200082 Issued in GA

Legal business name

INGLESIDE DENTAL ASSOICATES, P.C.

Practice address

2440 Ingleside Ave
Macon, GA 31204-2088

Phone

(478) 743-3441

Fax

(478) 743-1542

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Jackson Roberson, D.M.D.

Title

Owner

Phone

(478) 743-3441

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lee B Godfrey, D.M.D.

  • General Practice Dentistry
  • Macon, GA
  • NPI 1689789786
  NPD (past)
• Bradley C Roberson, D.M.D.

  • General Practice Dentistry
  • Macon, GA
  • NPI 1629183827
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780712224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 INGLESIDE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042088",
            "telephone_number": "478-743-3441",
            "fax_number": "478-743-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 INGLESIDE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042088",
            "telephone_number": "478-743-3441",
            "fax_number": "478-743-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGLESIDE DENTAL ASSOICATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-743-3441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "0200082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Infinite Wellness Services LLC
• Infinity Care LLC
• Infinity Laboratory
• Infinity Wellness Care, LLC
• Ingleside Counseling Resources
• Jasmine Lashea Ingram-Lusane, NP
• Inner-Connect Counseling, Consulting & Education SVC., Inc.
• Inpatient Consultants of Georgia, Inc
• Inspired Journeys
• Inspiring Healthy Lives, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.