Waldron and Lee Dentistry LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

WALDRON AND LEE DENTISTRY LLC

Practice address

2419 Roswell Rd
Marietta, GA 30062-4955

Phone

(770) 977-5547

NPI assigned

Apr 19, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Blair WaldronNPI 1528117223

Title

Dentist

Phone

(770) 977-5547

Specialties & licenses 2

Addresses

Other names 1

• Waldron and Lee Dentistry Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 4

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

• Jonathan Blair Waldron, DMD

  • Dentist
  • Marietta, GA
  • NPI 1528117223
  NPD Authorized official
• Christopher Bryan Lee, DMD

  • Student in an Organized Health Care Education/Training Program
  • Alpharetta, GA
  • NPI 1578829909
  NPD
• Edward Schlissel, DDS

  • General Practice Dentistry
  • Marietta, GA
  • NPI 1881751188
  NPD
• Savannah Lauren Short, DMD

  • General Practice Dentistry
  • Marietta, GA
  • NPI 1417527730
  NPD

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1972090504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 ROSWELL RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624955",
            "telephone_number": "770-977-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 ROSWELL RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624955",
            "telephone_number": "770-977-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDRON AND LEE DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-19",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "BLAIR",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "770-977-5547",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waldron and Lee Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wal-Mart Stores East, LP
• Wal-Mart Stores East, LP
• Lauren Walch, LCSW
• Monique Velia Walcott, MD
• Alison Nicole Wald, PA-C
• Jonathan Blair Waldron, DMD
• Jonathan Charles Waldron, DMD PC
• Vincent Timothy Waldron, PA-C
• Walgreen Co
• Walgreen Co

• Dentist in Marietta, GA
• Providers in Marietta, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.