Dentistry at Kennesaw Point

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013605 Issued in GA

Legal business name

DENTISTRY AT KENNESAW POINT

Practice address

1350 Wooten Lake Rd NW
Suite 203
Kennesaw, GA 30144-1344

Phone

(678) 275-2066

Fax

(678) 275-2074

NPI assigned

Mar 22, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kyandukhta Kalantari, DDSNPI 1780884221

Title

Owner

Phone

(678) 275-2066

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyandukhta B Kalantari, DDS

  • General Practice Dentistry
  • Kennesaw, GA
  • NPI 1780884221
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1003278904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 WOOTEN LAKE RD NW",
            "address_2": "SUITE 203",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441344",
            "telephone_number": "678-275-2066",
            "fax_number": "678-275-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WOOTEN LAKE RD NW",
            "address_2": "SUITE 203",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441344",
            "telephone_number": "678-275-2066",
            "fax_number": "678-275-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY AT KENNESAW POINT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "KALANTARI",
        "authorized_official_first_name": "KYANDUKHTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-275-2066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154041182L",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis G Bergin OD
• Hyacinth Dennis-Crooks, NP
• Dental Excellence of Kennesaw
• Dental One Associates (Kennesaw) LLC
• Dentfirst PC
• Donald Douglas Depew, DMD MS PC
• Deriche Agency Inc
• Annie Derthick, PHD
• Shyamal Desai, PHARMD.
• Destination Trans LLC Dba Anywhere You Need to Go

• General Practice Dentistry in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.