Lisa Kirshenbaum, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN011759 Issued in GA

Practice address

2750 Watts Dr NW
Kennesaw, GA 30144-2721

Phone

(770) 429-0955

Fax

(770) 429-0219

NPI assigned

Apr 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Dental Excellence of Kennesaw

  • General Practice Dentistry
  • Kennesaw, GA
  • NPI 1710048848
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114142171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 WATTS DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442721",
            "telephone_number": "770-429-0955",
            "fax_number": "770-429-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 WATTS DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442721",
            "telephone_number": "770-429-0955",
            "fax_number": "770-429-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSHENBAUM",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rae A King, MD
• Tamia King
• Racquel Kirkland-Johnson, FNP-C
• Jamonda Deshaye Kirkland
• Alina Kirkpatrick
• Julia Klein, MED
• Brice Stephen Knight, DPT
• Nancy Knight
• Alfred L Knox Jr., MD
• Chiuying Ko

• General Practice Dentistry in Kennesaw, GA
• Providers in Kennesaw, 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 Jul 8, 2007; 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.