Southern Smiles Dental Associates, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10186 Issued in GA

Legal business name

SOUTHERN SMILES DENTAL ASSOCIATES, LLC

Practice address

6612 Exchange PL
Morrow, GA 30260-2358

Phone

(770) 968-1720

Fax

(770) 968-1625

NPI assigned

Aug 30, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Larry L Webb, D.M.D.NPI 1104867472

Title

Manager

Phone

(770) 968-1720

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Larry L. Webb, D.M.D.

  • General Practice Dentistry
  • Morrow, GA
  • NPI 1104867472
  NPD (past) Authorized official

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255478400000",
    "number": "1942293576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6612 EXCHANGE PL",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602358",
            "telephone_number": "770-968-1720",
            "fax_number": "770-968-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6612 EXCHANGE PL",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602358",
            "telephone_number": "770-968-1720",
            "fax_number": "770-968-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SMILES DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2009-10-14",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-968-1720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Morrow, GA
• Providers in Morrow, 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 Oct 14, 2009; 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.