Skin Wellness Dermatology LC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SKIN WELLNESS DERMATOLOGY LC

Practice address

12 Paces Lakes Overlook
Dallas, GA 30157-1764

Phone

(770) 765-2386

NPI assigned

Nov 25, 2025

Last updated

Nov 25, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Evelina Pierce, MDNPI 1053845594

Title

Owner

Phone

(770) 765-2386

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Evelina N Pierce, M.D.

  • Dermatology Physician
  • Purchase, NY
  • NPI 1053845594
  NPD Authorized official

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

{
    "created_epoch": "1764028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1871455121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PACES LAKES OVERLOOK",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301571764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 PACES LAKES OVERLOOK",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301571764",
            "telephone_number": "770-765-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN WELLNESS DERMATOLOGY LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "EVELINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-765-2386",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharalynn Simmons, MS, LPC
• Tiffany Simmons
• Zachary Tyson Simpson
• Sines & Spines, LLC
• Delbert Glenn Sines Jr., D.C., C.M.E
• Natalie Carole Small-Freeman, REGISTERED NURSE
• Jazlyn Khalida Smalls
• Kristen Collier Smallwood, RN, CPS-AD
• Amanda Smith
• Champagnae Smith

• Dermatology Physician in Dallas, GA
• Providers in Dallas, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.