The Legacy Dental Group, LLC
NPI 1578330197ActiveOrganization· Dentist, General Practice· Evans, GA
Dentist, General Practice in Evans, Georgia, registered in NPPES in December 2023. The authorized official on file is Jonathan Keith Bookout, DMD, Owner/Dentist.
Overview
| NPI | 1578330197 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 4, 2023 |
| Last updated in NPPES | Mar 20, 2025 |
| Certified by provider | Mar 20, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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