D.Keith Fortson,D.M.D.,P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN008764 Issued in GA

Legal business name

D.KEITH FORTSON,D.M.D.,P.C.

Practice address

151 S Harkness St
Jackson, GA 30233-1832

Phone

(770) 775-4550

Fax

(770) 775-4338

NPI assigned

Feb 25, 2007

Last updated

May 29, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dennis Keith Fortson, D.M.D.NPI 1548607765

Title

Ceo

Phone

(770) 775-4550

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dennis Keith Fortson, D.M.D

  • General Practice Dentistry
  • Jackson, GA
  • NPI 1548607765
  NPD (past) Authorized official

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

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1033245196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 S HARKNESS ST",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331832",
            "telephone_number": "770-775-4550",
            "fax_number": "770-775-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S HARKNESS ST",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331832",
            "telephone_number": "770-775-4550",
            "fax_number": "770-775-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D.KEITH FORTSON,D.M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-25",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "FORTSON",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-775-4550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN008764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000136694A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dr. Robert H. Pinckney
• Young Dreaden, NP

• General Practice Dentistry in Jackson, GA
• Providers in Jackson, 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 May 29, 2013; 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.