Charles Edward Kirby, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN014933 Issued in GA

Practice address

45 W Crossville Rd Ste 505
Roswell, GA 30075-2964

Phone

(770) 993-7424

NPI assigned

Jun 28, 2012

Sex

Male

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 KS

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.

• Wyman B Martin DDS PC

  • Dentist
  • Roswell, GA
  • NPI 1720297161
  NPD (past)

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1316201825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 W CROSSVILLE RD STE 505",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752964",
            "telephone_number": "770-993-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W CROSSVILLE RD STE 505",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752964",
            "telephone_number": "770-993-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014933",
            "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": "DN014933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Yuhr King, M.A., CCC-SLP
• Lydia J Kinkead, D.C,
• Brittany Kinser, NP
• Carly Jean Kiomall, OD, MPH
• Karen Kipley, BCBA
• Claire Kirkland
• Delores K. Kirkpatrick, M.D.
• Joseph Franklin Kirkpatrick, LPC
• Josephine Kim Kirkup, MA, LPC
• Joel I Kirson, M.D.

• General Practice Dentistry in Roswell, GA
• Providers in Roswell, 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 Mar 14, 2023; 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.