NPI age
19 years
Enumerated 2006-07-11
● Active Type 2 · Organization
West Georgia Dental Of La Grange,pc
West Georgia Dental Of La Grange,pc is 1 of 4309 dentist organizations in Georgia.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Allen
President
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 4309 active dentist providers in Georgia.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-07Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
1555 Doctors Dr Ste 105
Lagrange, GA 302404132
Mailing address
1555 Doctors Dr Ste 105
Lagrange, GA 302404132
Authorized official
Tara Milligan Allen, DDS
President
📞 7068128220
Specialties
-
Dentist PrimaryA 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.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 167795 | DORAL/WELLCARE |
| 01 (GA) | 100198 | AVESIS/PEACHSTATE |
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.