NPIMap

Individual provider Active NPI

Juanita Shirley Adkins, DMD

  • Dentist
  • McDonough, GA
National Provider Identifier
1295845543
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN013121 Issued in GA
Practice address
400 McDonough Pkwy
McDonough, GA 30253-8946
Phone
(770) 957-5214
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN013121 GA Primary

Addresses

Primary practice location

400 McDonough Pkwy
McDonough, GA 30253-8946

Mailing address

400 McDonough Pkwy
McDonough, GA 30253-8946
Phone (770) 957-5214

Other identifiers 1

IdentifierTypeStateIssuer
750112165AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL McDonough Other

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

LicenseStateTypeSpecialty
DN013121GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jsa Dental Associates McDonough PC PastSince Aug 23, 2020 Accepting new patients
Downtown Dental LLC Dentist Past Accepting new patients
Honey Creek Dental Association PastSince Aug 23, 2020 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1295845543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MCDONOUGH PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538946",
            "telephone_number": "770-957-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MCDONOUGH PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538946",
            "telephone_number": "770-957-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADKINS",
        "first_name": "JUANITA",
        "middle_name": "SHIRLEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "750112165A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "McDonough",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "McDonough",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jsadamanger@gmail.com",
            "address_1": "400 McDonough Pkwy",
            "city": "McDonough",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302538946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.