Clarence Cornell Kegler II, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 012376 Issued in GA

Practice address

3772 Satellite Blvd
Suite 103
Duluth, GA 30096-5681

Phone

(770) 476-9511

Fax

(770) 623-1923

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245265503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3772 SATELLITE BLVD",
            "address_2": "SUITE 103",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965681",
            "telephone_number": "770-476-9511",
            "fax_number": "770-623-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3772 SATELLITE BLVD",
            "address_2": "SUITE 103",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965681",
            "telephone_number": "770-476-9511",
            "fax_number": "770-623-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEGLER",
        "first_name": "CLARENCE",
        "middle_name": "CORNELL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN 012376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mozhgan Karimi, PTA
• Mary-Sydney Karsh, MD
• Dorigen K Kasparek, MD
• Kathryn Vaughn LLC
• Kelley Kawamoto, BS, DC
• Barbara Joan Kell, R.N.C.
• Tammy Thompson Keller, M.A., CADC-II
• Alexa Kelly
• Megan Renee Kelly, M.S., CCC-SLP
• Natalie Kelly

• General Practice Dentistry in Duluth, GA
• Providers in Duluth, 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.