Youth Dentistry of Macon, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

YOUTH DENTISTRY OF MACON, PC

Practice address

1536 Eisenhower Pkwy
Macon, GA 31206-3130

Phone

(478) 781-4333

Fax

(478) 781-4331

NPI assigned

Feb 18, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Linda S Zoeller

Title

VP, Legal Licensing & Credentialing

Phone

(478) 781-4333

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1140220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473120000000",
    "number": "1851366462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 EISENHOWER PKWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312063130",
            "telephone_number": "478-781-4333",
            "fax_number": "478-781-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 EISENHOWER PKWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312063130",
            "telephone_number": "478-781-4333",
            "fax_number": "478-781-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH DENTISTRY OF MACON, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-18",
        "last_updated": "2016-09-06",
        "status": "A",
        "authorized_official_last_name": "ZOELLER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP, LEGAL LICENSING & CREDENTIALING",
        "authorized_official_telephone_number": "478-781-4333",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1905601",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "478300670A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "539109",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Albarra Younis
• Your Corner Drug Store LLC
• Your Doctor'S After Hours, LLC
• Ahmed Yousef, PT, PHD
• Marguerite Youssef, PHARMACIST
• Youth Development Organization of America
• Jennifer Bo Ling Yu-Datta, MD
• Sarah Marie Zaccagnini, APRN
• Shayan Greg Zafrani, M.D.
• Ihab Zaki Zaggout, MD

• General Practice Dentistry in Macon, GA
• Providers in Macon, 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 Sep 6, 2016; 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.