Lewis Family Dentistry, LLC
Dentist in Canton, GA. Organization (NPI-2).
NPI number1104847136
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1104847136
- Entity type
- Organization (NPI-2)
- Legal business name
- Lewis Family Dentistry, LLC
- Organization subpart
- No
- Enumeration date
- Jul 23, 2006
- Last updated
- Aug 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 11977 | GA | Yes |
Practice location
7768 Cumming HwySuite 100
Canton, GA 30114-9314
Phone 678-493-2204 · Fax 678-493-2275
Mailing address
7768 Cumming HwySuite 100
Canton, GA 30114-9314
Phone 678-493-2204 · Fax 678-493-2275
Authorized official
Elizabeth T Lewis
Owner
6784932204
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