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Lana L. Mamut, Dmd, PC

Clinic/Center, Dental in Suwanee, GA. Organization (NPI-2).

NPI number1437487550
StatusActive
Last updated in NPPESJul 29, 2013

Details

NPI
1437487550
Entity type
Organization (NPI-2)
Legal business name
Lana L. Mamut, Dmd, PC
Organization subpart
No
Enumeration date
Dec 1, 2009
Last updated
Jul 29, 2013

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 codeDescriptionLicenseStatePrimary
261QD0000X Clinic/Center, DentalDN012943GAYes

Other names

  • Family Dentistry Of Forsyth (Doing Business As)

Practice location

3130 Mathis Airport Pkwy
Ste 309
Suwanee, GA 30024-9131

Phone 404-579-0519

Mailing address

3130 Mathis Airport Pkwy
Ste 309
Suwanee, GA 30024-9131

Phone 404-579-0519

Authorized official

Lana Lvovna Mamut
Owner Dentist
4045790519

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dental Clinic/Center providers in Suwanee, GA

All 10 Dental Clinic/Center providers in Suwanee · All 2,103 providers in Suwanee

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