LAKE OCONEE ORAL AND MAXILLOFACIAL SURGERY, P.C. (NPI# 1154681195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154681195 |
| Entity Type | Organization |
| Organization Name | LAKE OCONEE ORAL AND MAXILLOFACIAL SURGERY, P.C. |
| Practice Address |
1031 Founders Row Greensboro GA 30642 |
| Practice Telephone | 7064541500 |
| Practice Fax Number | 7064541501 |
| Mailing Telephone | 7064541500 |
| Mailing Fax Number | 7064541501 |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2012-06-29 |
| Authorized Official Name | DR. DAVID CLAY MILLER (PRESIDENT) |
| Authorized Official Telephone | 7064541500 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN012341 | GA | Dental Providers |
| Street Address |
1031 FOUNDERS ROW |
| City | GREENSBORO |
| State | GA |
| Zip Code | 30642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992861686 | David Clay Miller | Dentist | 1031 Founders Row, Greensboro, GA 30642-5260 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821575176 | Donald Matson Keiser IIi | Pharmacist | 6380 Lake Oconee Parkway, Greensboro, GA 30642 | 2018-07-19 |
| 1427575844 | Kathleen Mcgrady | Psychologist | 1121 Careywood St, Greensboro, GA 30642 | 2017-08-25 |
| 1851733281 | April Jackson Powell | Physical Therapist | 1000 Cowles Clinc Way Ste D-100, Greensboro, GA 30642 | 2013-07-26 |
| 1003046673 | Apalachee Medical Supply & Mobility Inc | Durable Medical Equipment & Medical Supplies | 1000 Cowles Clinic Way, Aspen Building A-200, Greensboro, GA 30642 | 2009-07-17 |
| 1487808754 | Wendy C Pearson | Nurse Practitioner | 1000 Cowles Clinc Way Ste 300, Greensboro, GA 30642 | 2008-11-12 |
| 1144481516 | Kingdom Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 1020 Park Drive, Suite B, Greensboro, GA 30642 | 2008-06-18 |
| 1538369343 | Jerry Allen Spivey Jr. | Anesthesiology | 1030 Founders Row, Greensboro, GA 30642 | 2007-07-19 |
| 1578766309 | Richard Norman Lee | Dentist | 1041 Parkside Commons, Suite 104, Greensboro, GA 30642 | 2007-06-08 |
| 1609085950 | Lott Cuffie Southwest Properties | Dentist | 1050 Parkside Commons, Suite 103, Greensboro, GA 30642 | 2007-05-22 |
| 1649320490 | Greene County Nursing Center LLC | Skilled Nursing Facility | 1211 Siloam Road, Greensboro, GA 30642 | 2007-01-12 |
| Find all providers in zip 30642 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780080655 | Robert L Stutts IIi Dmd Paii | Dentist | 200 E Wendover Ave Ste B, Greensboro, NC 27401-1227 | 2014-11-05 |
| 1801101803 | Scott M Jensen Dmd Pa | Dentist | 920 Cherry St, Greensboro, NC 27401-1422 | 2010-08-13 |
| 1801917190 | Mohorn, Belcher & Gollehon, Dds. Pa | Dentist | 2105 Braxton Lane, Suite 102, Greensboro, NC 27408 | 2007-04-03 |
| 1699899823 | Todd Gene Owsley | Dentist | 2516 Oakcrest Avenue, Suite B, Greensboro, NC 27408-1933 | 2007-03-16 |
| 1952458325 | Christopher L. Durham Dds Pa | Dentist | 6 N Pointe Ct Ste 101, Greensboro, NC 27408-3187 | 2007-01-05 |
| 1992861686 | David Clay Miller | Dentist | 1031 Founders Row, Greensboro, GA 30642-5260 | 2006-12-28 |
| 1881770089 | Scott Mckenzie Jensen | Dentist | 920 Cherry Street, Greensboro, NC 27401 | 2006-10-31 |
| 1952315301 | Dr Scott R Rehm Dds and Dr Robert J Riggs Dds Md Pa | Dentist | 2708 Henry St, Greensboro, NC 27405 | 2006-07-28 |
| 1043241755 | Justin Lael Drab | Dentist | 3824 N Elm St Ste 209, Greensboro, NC 27455-2734 | 2006-07-05 |
| 1952375784 | Steven G Gollehon | Dentist | 301 East Wendover Ave, Suite 111, Greensboro, NC 27401 | 2006-02-16 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 30642 |
Please comment or provide details below to improve the information on LAKE OCONEE ORAL AND MAXILLOFACIAL SURGERY, P.C..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.