Tony U. Lim, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12054 Issued in GA

Practice address

102 North Central Ave
Adairsville, GA 30103

Phone

(770) 773-7311

NPI assigned

Apr 12, 2007

Last updated

Feb 15, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1952525776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 NORTH CENTRAL AVE",
            "address_2": "P. O. BOX 433",
            "city": "ADAIRSVILLE",
            "state": "GA",
            "postal_code": "30103",
            "telephone_number": "770-773-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 NORTH CENTRAL AVE",
            "city": "ADAIRSVILLE",
            "state": "GA",
            "postal_code": "30103",
            "telephone_number": "770-773-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "TONY",
        "middle_name": "U.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "12054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00887719A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily King Johnson, FNP
• Andrea Harner Kovacic, MD
• Michael Tyler Land, MD
• David Lane, DMD
• Kandi Lewis
• Janna Novotny Lister, NP-C
• Byron A Littlefield, D.O.
• Donna Bing Mantooth, L.P.C.
• Mona M McBrayer, OTR/L
• Helen Clair Medlin, NP-C

• General Practice Dentistry in Adairsville, GA
• Providers in Adairsville, 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 Feb 15, 2008; 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.