Latonya Wade-Crear, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012877 Issued in GA

Practice address

8180 Mall Pkwy
Suite 810
Lithonia, GA 30038-6911

Phone

(770) 484-4994

Fax

(770) 484-4575

NPI assigned

Feb 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

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.

• Childrens Dentistry at Stonecrest

  • Pediatric Dentistry
  • Lithonia, GA
  • NPI 1790046464
  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1831224153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2647 HUNTERS PLACE LNDG",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300177829",
            "telephone_number": "336-253-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8180 MALL PKWY",
            "address_2": "SUITE 810",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386911",
            "telephone_number": "770-484-4994",
            "fax_number": "770-484-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE-CREAR",
        "first_name": "LATONYA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "785926443C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victory House Health Care Services
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• Visiting Labs, LLC
• Thomas Nicholas Vollmar, PT, DPT
• Quanghuy Vu, M.D.
• Tambaneka Wade, CN0028858650
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP

• General Practice Dentistry in Lithonia, GA
• Providers in Lithonia, 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 Mar 31, 2017; 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.