NPIMap

Organization Active NPI

PK Dental

  • General Practice Dentistry
  • Marietta, GA
National Provider Identifier
1164675203
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PK DENTAL
Practice address
1410 Terrell Mill Rd
Marietta, GA 30067
Phone
(770) 984-9000
Fax
(770) 984-9256
NPI assigned
Nov 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Authorized official

Name
William KapganNPI 1912051202
Title
Owner
Phone
(770) 984-9000

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X
Dental Clinic/Center 261QD0000X DN013274 GA

Addresses

Primary practice location

1410 Terrell Mill Rd
Marietta, GA 30067

Mailing address

1410 Terrell Mill Rd
Marietta, GA 30067
Phone (770) 984-9000

Other identifiers 2

IdentifierTypeStateIssuer
644170460DOtherGADR WILLIAM KAPGAN
68579198COtherGADR INESSA PLAVNIK

Other names 2

  • Dental World Doing business as
  • Dental World of Marietta Doing business as

National Provider Directory

National Provider Directory

Locations

1410 Terrell Mill Rd SE
Marietta, GA 30067
Phone (770) 984-9000

2468 Windy Hill Rd SE
Ste 400
Marietta, GA 30067
Phone (404) 800-3000

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1164675203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 TERRELL MILL RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30067",
            "telephone_number": "770-984-9000",
            "fax_number": "770-984-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 TERRELL MILL RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30067",
            "telephone_number": "770-984-9000",
            "fax_number": "770-984-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-03",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "KAPGAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-984-9000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DN013274",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR WILLIAM KAPGAN",
            "identifier": "644170460D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR INESSA PLAVNIK",
            "identifier": "68579198C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental World",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dental World of Marietta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 26, 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.