NPIMap

Organization Active NPI

Kennestone Dental Designs, LLC

  • General Practice Dentistry
  • Marietta, GA
National Provider Identifier
1093019978
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN010518 Issued in GA
Legal business name
KENNESTONE DENTAL DESIGNS, LLC
Practice address
709 Canton Rd NE
Suite 210
Marietta, GA 30060-8968
Phone
(770) 426-4188
Fax
(770) 421-8122
NPI assigned
Jan 6, 2011
Last updated
Mar 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Authorized official

Name
Dr. Barry P Smith, DDSNPI 1023187986
Title
Dentist
Phone
(770) 426-4188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN010518 GA Primary

Addresses

Primary practice location

709 Canton Rd NE
Suite 210
Marietta, GA 30060-8968

Mailing address

709 Canton Rd NE
Suite 210
Marietta, GA 30060-8968
Phone (770) 426-4188

Other names 1

  • Dr. Barry Smith Former legal business name

National Provider Directory

National Provider Directory

Locations

709 Canton Rd NE
Ste 210
Marietta, GA 30060
Phone (770) 426-4188

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1093019978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 CANTON RD NE",
            "address_2": "SUITE 210",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608968",
            "telephone_number": "770-426-4188",
            "fax_number": "770-421-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 CANTON RD NE",
            "address_2": "SUITE 210",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608968",
            "telephone_number": "770-426-4188",
            "fax_number": "770-421-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNESTONE DENTAL DESIGNS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-06",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "770-426-4188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN010518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Barry Smith",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.