NPIMap

Organization Active NPI

Centre of Panola Cosmetic & Family Dentistry P.C.

  • General Practice Dentistry
  • Lithonia, GA
National Provider Identifier
1942021555
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CENTRE OF PANOLA COSMETIC & FAMILY DENTISTRY P.C.
Practice address
3035 Panola Rd Ste a
Lithonia, GA 30038-2494
Phone
(770) 498-3744
NPI assigned
Oct 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Ida Lanier, DDSNPI 1164594032
Title
President
Phone
(770) 498-3744

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 DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3035 Panola Rd Ste a
Lithonia, GA 30038-2494

Mailing address

3035 Panola Rd Ste a
Lithonia, GA 30038-2494
Phone (770) 498-3744

National Provider Directory

National Provider Directory

Locations

3035 Panola Rd
Ste A
Stonecrest, GA 30038
Phone (770) 498-3744

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1942021555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 PANOLA RD STE A",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382494",
            "telephone_number": "770-498-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 PANOLA RD STE A",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382494",
            "telephone_number": "770-498-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRE OF PANOLA COSMETIC & FAMILY DENTISTRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "LANIER",
        "authorized_official_first_name": "IDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-498-3744",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.