NPIMap

Organization Active NPI

Lakeland Family Dentistry

  • General Practice Dentistry
  • Lakeland, GA
National Provider Identifier
1912018391
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013346 Issued in GA
Legal business name
LAKELAND FAMILY DENTISTRY
Practice address
33 Hospital Dr
Lakeland, GA 31635-5716
Phone
(229) 482-1100
Fax
(229) 482-1103
NPI assigned
Aug 31, 2006
Last updated
Jun 14, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Authorized official

Name
Dr. Eric Alan Castor, D.M.DNPI 1831355122
Title
Dentist
Phone
(229) 482-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN013346 GA Primary

Addresses

Primary practice location

33 Hospital Dr
Lakeland, GA 31635-5716

Mailing address

33 Hospital Dr
Lakeland, GA 31635-5716
Phone (229) 482-1100

Other identifiers 1

IdentifierTypeStateIssuer
426342256AMedicaidGA

National Provider Directory

National Provider Directory

Locations

33 Hospital Dr
Lakeland, GA 31635
Phone (229) 482-1100

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1912018391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 HOSPITAL DR",
            "city": "LAKELAND",
            "state": "GA",
            "postal_code": "316355716",
            "telephone_number": "229-482-1100",
            "fax_number": "229-482-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 HOSPITAL DR",
            "city": "LAKELAND",
            "state": "GA",
            "postal_code": "316355716",
            "telephone_number": "229-482-1100",
            "fax_number": "229-482-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "CASTOR",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "229-482-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426342256A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.