Wallace C Lail, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6981 Issued in GA

Practice address

3415 E Lawrenceville St
Duluth, GA 30096-3354

Phone

(770) 476-5227

NPI assigned

Apr 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

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.

• SWL Dental

  • Dental Clinic/Center
  • Duluth, GA
  • NPI 1881981181
  NPD (past)

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1821263831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 E LAWRENCEVILLE ST",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963354",
            "telephone_number": "770-476-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 E LAWRENCEVILLE ST",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963354",
            "telephone_number": "770-476-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIL",
        "first_name": "WALLACE",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "6981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lysbeth Caluya Lagat, RN
• Oi Lam Lai
• Lail Family Dentistry P.C.
• Carson Lail, DMD
• Slade Wallace Lail, D.D.S.
• Wood Lajeunesse
• Lakeside Allergy Asthma and Immunology LLC
• Joseph J Lamb Jr., PHARM.D.
• Lamberson'S Home Care, Inc.
• Lan & Ocean Aesthetics Allergy and Primary Care LLC

• General Practice Dentistry in Duluth, GA
• Providers in Duluth, 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 Apr 30, 2008; 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.