LIBERTY TRAILS ENDODONTICS, LLC (NPI# 1346644176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346644176 |
| Entity Type | Organization |
| Organization Name | LIBERTY TRAILS ENDODONTICS, LLC |
| Other Organization Name | COASTAL ENDODONTICS |
| Practice Address |
111 E Mills Ave Hinesville GA 31313-2616 |
| Practice Telephone | 9124634405 |
| Practice Fax Number | 9124634939 |
| Mailing Telephone | 9124634405 |
| Mailing Fax Number | 9124634939 |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2014-10-22 |
| Authorized Official Name | CHRISTOPHER LEA (OWNER) |
| Authorized Official Telephone | 9127565960 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
DN013079 | GA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Coastal Endodontics | Doing Business As Name - Organization |
| Street Address |
111 E MILLS AVE |
| City | HINESVILLE |
| State | GA |
| Zip Code | 31313-2616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447877469 | Brennan Roger Milbury | Naturopath | 4876 Ga 196 W, Hinesville, GA 31313 | 2020-06-26 |
| 1558982660 | Hinesville Day Spa LLC | Massage Therapist | 951 E G Miles Pkwy, Suite B, Hinesville, GA 31313 | 2020-04-29 |
| 1104459932 | Johnny Roger Terry | Counselor | 115 W Oglethorpe Hwy, Hinesville, GA 31313 | 2020-02-20 |
| 1043875594 | Liberty Regional Medical Center | Pharmacy | 462 Elma G. Miles Parkway, Hinesville, GA 31313 | 2019-05-09 |
| 1730646811 | Jennifer Lee Reffeor | Nurse Practitioner | 109 W Oglethorpe Highway, Hinesville, GA 31313 | 2019-02-26 |
| 1760907968 | Kenya Dominic | Specialist | 445 E.g. Miles Parkway Ste 207, Hinesville, GA 31313 | 2017-08-08 |
| 1902358393 | Tricia Amelung | Nurse Practitioner | 512 South Main St., Suite 1a, Hinesville, GA 31313 | 2016-11-01 |
| 1881065449 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 801-a East General Stewart Way, Hinesville, GA 31313 | 2015-10-08 |
| 1245614916 | Tracey Bazemore | Counselor | 318 S. Wellborn Street, Suite C, Hinesville, GA 31313 | 2015-07-13 |
| 1831592021 | Jennifer Grisnik | Behavioral Analyst | 306 N. Main St., Suite 1a1, Hinesville, GA 31313 | 2014-10-01 |
| Find all providers in zip 31313 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764180 | John O. Green, II, Dds, PC | Dentist | 6126 Prestley Mill Rd Ste J, Douglasville, GA 30134-5624 | 2020-09-10 |
| 1104434232 | Conyers Endodontic Center PC | Dentist | 1920 Highway 20 Se Ste A, Conyers, GA 30013-2048 | 2020-07-15 |
| 1790288678 | Crabapple Endodontics | Dentist | 12385 Crabapple Rd Ste 150, Alpharetta, GA 30004-6357 | 2018-03-16 |
| 1326552522 | Lucas Blaine Connor | Dentist | 3625 Braselton Hwy Ste 101, Dacula, GA 30019-4696 | 2017-11-27 |
| 1710382007 | Golden Isles Endodontics, LLC | Dentist | 1804 Frederica Rd Ste B, Saint Simons Island, GA 31522-2044 | 2014-10-29 |
| 1194136929 | Jimmy W. Arnold | Dentist | 152 N Crest Blvd Ste A, Macon, GA 31210-1847 | 2014-05-14 |
| 1629418371 | Young Okeke | Dentist | 6595 Roswell Rd Ste G-3040, Atlanta, GA 30328-3152 | 2013-06-26 |
| 1720342694 | Lake Oconee Endodontics, LLC | Dentist | 112 Harmony Crossing, Suite 1, Eatonton, GA 31024-9536 | 2012-06-26 |
| 1275891541 | Alison Stpaul | Dentist | 1705 Ga-20, Suite 200, Mcdonough, GA 30253 | 2012-04-24 |
| 1780942144 | Marcus Robert Miller | Dentist | 2151 Fountain Dr Ste 206, Snellville, GA 30078-6753 | 2012-04-23 |
| Find all providers with the same taxonomy | ||||
| City | HINESVILLE |
| Zip Code | 31313 |
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| 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.