Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lakeside Oral Surgery, LLC

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1225732472

Lakeside Oral Surgery, LLC is an Oral & Maxillofacial Surgery (D.M.D.) in Eatonton, Georgia. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1097 Lake Oconee Pkwy Ste 101
Eatonton, GA 31024-9510
Phone: (706) 916-4764
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X

Record details

NPI number1225732472
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Tomlinson — Credentialing Specialist · (404) 410-1340
NPI enumeratedMarch 29, 2023
Last updated in NPPESMarch 29, 2023
Certification dateMarch 29, 2023
Mailing address1097 Lake Oconee Pkwy Ste 101, Eatonton, GA 31024-9510