Larry V. Calloway, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN010304 Issued in GA

Practice address

965 Battlefield Pkwy
Fort Oglethorpe, GA 30742-3945

Phone

(706) 866-8412

Fax

(706) 861-3354

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1982729307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 BATTLEFIELD PKWY",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423945",
            "telephone_number": "706-866-8412",
            "fax_number": "706-861-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 BATTLEFIELD PKWY",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423945",
            "telephone_number": "706-866-8412",
            "fax_number": "706-861-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLOWAY",
        "first_name": "LARRY",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN010304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "DS0000004699",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "DN010304",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Broyles
• Steven G Burdette, ATC
• Erin Burns
• David Allen Burris Sr.
• C & C Medical Group, Inc.
• Rodolfo Mario Cardenas, MD
• Sandra Jean Carmichael, MD
• Andrea Carpenter, PMHNP-BC
• Ashley Carter, LPC
• Christie Case, FNP-C

• General Practice Dentistry in Fort Oglethorpe, GA
• Providers in Fort Oglethorpe, 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 Sep 18, 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.