Kent M. Mattison, D.M.D., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN008284 Issued in GA

Legal business name

KENT M. MATTISON, D.M.D., P.C.

Practice address

2381 Main St E Ste B
Snellville, GA 30078-3358

Phone

(770) 972-4666

Fax

(770) 972-9054

NPI assigned

Mar 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kent M Mattison, D.M.D.NPI 1922024454

Title

President

Phone

(770) 972-4666

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kent M Mattison, D.M.D.

  • Dentist
  • Snellville, GA
  • NPI 1922024454
  NPD (past) Authorized official

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114059706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2381 MAIN ST E STE B",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783358",
            "telephone_number": "770-972-4666",
            "fax_number": "770-972-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2381 MAIN ST E STE B",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783358",
            "telephone_number": "770-972-4666",
            "fax_number": "770-972-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT M. MATTISON, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATTISON",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-972-4666",
        "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": "DN008284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Kelly, RBT
• Kelly Kencade-Pichon
• Andrea M Kennedy
• Katherine A Kennedy, P.A.-C
• Mary C Kennedy, O.D.
• Lindsay Michelle Kent, PTA
• Jennifer L Kephart, SLP
• Usman Manzoor Khalid, M.D.
• Sami Osman Khan, MD
• Kiara Kiah, RBT

• General Practice Dentistry in Snellville, GA
• Providers in Snellville, 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 Aug 22, 2020; 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.