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DR. LEROY JUSTICE .D.D.S NPI 1619185576


NPI Information

NPI: 1619185576
Provider Name: DR. LEROY JUSTICE, .D.D.S
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
12900 BROAD ST
SPARTA, GA
ZIP 31087
Phone: (706) 444-6886
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DR. Leroy Justice, .D.D.S is a general practice dentist in Sparta, GA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Leroy Justice, .D.D.S NPI is 1619185576. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12900 BROAD ST
SPARTA, GA
ZIP 31087-737
Phone: (706) 444-6886
Fax: (706) 444-7779

The enumeration date for this NPI number is 5/21/2007 and was last updated on 7/12/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice8775GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100254943BMEDICAIDGEORGIA
200254493AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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