Active NPI
Daniel Whitner
- Endodontics
- Kennesaw, GA
National Provider Identifier
1013053180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 8100
- Practice address
- 2105 Barrett Park Dr NW
Kennesaw, GA 30144-7080 - Phone
- (770) 421-8653
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 8100 | GA | Primary |
Addresses
Primary practice location
2105 Barrett Park Dr NW
Kennesaw, GA 30144-7080
Mailing address
2105 Barrett Park Dr NW
Kennesaw, GA 30144-7080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8100 | GA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013053180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2105 BARRETT PARK DR NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301447080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 BARRETT PARK DR NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301447080",
"telephone_number": "770-421-8653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITNER",
"first_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "GA",
"license": "8100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.