Carissa Eve Campos, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN122551 Issued in GA

Practice address

3384 Cobb Pkwy NW Ste 130
Acworth, GA 30101-8784

Phone

(678) 574-8622

NPI assigned

Apr 3, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

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.

• Acworth Smiles Dentistry, PC

  dba Acworth Smiles Dentistry

  • General Practice Dentistry
  • Acworth, GA
  • NPI 1326453317
  NPD (past)

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1144563560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 WOODWALK TRCE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303398475",
            "telephone_number": "631-355-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3384 COBB PKWY NW STE 130",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018784",
            "telephone_number": "678-574-8622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2265 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100352231",
            "country_code": "US",
            "telephone_number": "212-289-6650",
            "fax_number": "212-289-0280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "CARISSA",
        "middle_name": "EVE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057724",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherie Nicole Byrd, M.D.
• C & S Health and Rehabilitative Service, LLC
• Brian Callahan, D.C.
• Ashley Nicole Campbell, FNP
• Michael Andrew Wade Campbell
• Candid Hearts Healthcare Services LLC
• John Michael Caraway, DPT
• Care Assurance LLC
• Care Intl LLC
• Yelena Zoya Carlisle, M.S. CCC-SLP, CLC

• General Practice Dentistry in Acworth, GA
• Providers in Acworth, 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 Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.