Kelly Hughes, Dmd, LLC
Dentist, Pediatric Dentistry in Evans, GA. Organization (NPI-2).
NPI number1114441995
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1114441995
- Entity type
- Organization (NPI-2)
- Legal business name
- Kelly Hughes, Dmd, LLC
- Organization subpart
- No
- Enumeration date
- Aug 2, 2017
- Last updated
- Jul 21, 2022
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 |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | DN012769 | GA | Yes |
Other names
- Southern Smiles Pediatric Dentistry (Doing Business As)
Practice location
400 Town Park Blvd Ste 400Evans, GA 30809-3471
Phone 706-288-1100 · Fax 706-288-1060
Mailing address
400 Town Park Blvd Ste 400Evans, GA 30809-3471
Phone 706-288-1100 · Fax 706-288-1060
Authorized official
Kelly Hughes
Owner/Dentist
7063998601
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