Individual provider Active NPI

Ketan G Ginoya, DMD

  • General Practice Dentistry
  • Peachtree Cty, GA
National Provider Identifier
1033497409
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN014859 Issued in GA
Practice address
5000 Shakerag HL
Peachtree Cty, GA 30269-3367
Phone
(770) 631-0044
NPI assigned
Aug 2, 2011
Last updated
Feb 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN014859 GA Primary
General Practice Dentistry 1223G0001X 16179 MD
General Practice Dentistry 1223G0001X DN1855814 MA

Addresses

Primary practice location

5000 Shakerag HL
Peachtree Cty, GA 30269-3367

Mailing address

5000 Shakerag HL
Peachtree City, GA 30269-3367
Phone (770) 631-0044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160104000962 MD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8729380019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN014859GAMDGeneral Practice Dentistry
DN1855814MAMDGeneral Practice Dentistry
16179MDMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Karma Dental LLC General Practice CurrentSince Sep 23, 2024 Accepting new patients
Mahima Dental LLC CurrentSince Jun 8, 2025 Accepting new patients
Aesthetic Restorative Dentistry, P. C. Past Accepting new patients
Akj Dental DDS LLC PastSince Jan 1, 2021 Accepting new patients
Fenwick Dental Associates PastSince Jan 1, 2021 Accepting new patients

Locations

4511 Chamblee Dunwoody Rd
Ste A2
Dunwoody, GA 30338
Phone (404) 806-9799

5000 Shakerag Hl
Peachtree Cty, GA 30269
Phone (770) 631-0044

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1033497409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 SHAKERAG HL",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693367",
            "telephone_number": "770-631-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 SHAKERAG HL",
            "city": "PEACHTREE CTY",
            "state": "GA",
            "postal_code": "302693367",
            "telephone_number": "770-631-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINOYA",
        "first_name": "KETAN",
        "middle_name": "G",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-02",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014859",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "16179",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855814",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree Cty, GA

Sources for this page

Verify at the official NPI Registry.