Active NPI
Martin E Kersh, D.M.D.,P.C.
- Endodontics
- Lawrenceville, GA
National Provider Identifier
1043354368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 11140
- Practice address
- 559 Old Norcross Rd
Lawrenceville, GA 30045-4313 - Phone
- (770) 339-6393
- NPI assigned
- Feb 19, 2007
- Last updated
- Jun 7, 2010
- 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 | 11140 | GA | Primary |
Addresses
Primary practice location
559 Old Norcross Rd
Lawrenceville, GA 30045-4313
Mailing address
559 Old Norcross Rd
Lawrenceville, GA 30045-4313
Phone (770) 339-6393
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 |
|---|---|---|---|
| 11140 | GA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275868800000",
"number": "1043354368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "559 OLD NORCROSS RD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300454313",
"telephone_number": "770-339-6393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "559 OLD NORCROSS RD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300454313",
"telephone_number": "770-339-6393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERSH",
"first_name": "MARTIN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.M.D.,P.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-19",
"last_updated": "2010-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "GA",
"license": "11140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.