Active NPI
Kimberlyn R Atherton Jenkins, DDS
- General Practice Dentistry
- Roswell, GA
National Provider Identifier
1164484390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN015925
- Practice address
- 245 Boulder Dr
Roswell, GA 30075-4158 - Phone
- (540) 230-7835
- NPI assigned
- Apr 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN015925 | GA | Primary |
| Dentist | 122300000X | 0401410261 | VA |
Addresses
Primary practice location
245 Boulder Dr
Roswell, GA 30075-4158
Mailing address
245 Boulder Dr
Roswell, GA 30075-4158
Phone (540) 230-7835
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 |
|---|---|---|---|
| 0401410261 | VA | MD | Dentist |
| DN015925 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New River Valley Dental, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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 Clinic/Center
- Blacksburg, VA
- NPI 1821650607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756771200000",
"number": "1164484390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 BOULDER DR",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300754158",
"telephone_number": "540-230-7835",
"fax_number": "540-951-2268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 BOULDER DR",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300754158",
"telephone_number": "540-230-7835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATHERTON JENKINS",
"first_name": "KIMBERLYN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-04",
"last_updated": "2025-09-02",
"certification_date": "2025-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN015925",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401410261",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.