Individual provider Active NPI

Laura McKenzie, DMD

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1336791391
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015874 Issued in GA
Practice address
2090 Dunwoody Club Dr Ste 105
Atlanta, GA 30350-5406
Phone
(770) 998-0111
NPI assigned
Jul 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN015874 GA Primary

Addresses

Primary practice location

2090 Dunwoody Club Dr Ste 105
Atlanta, GA 30350-5406

Mailing address

1469 Livingston Dr SW
Marietta, GA 30064-5220
Phone (404) 997-9237

Other practice location 1

2282 Peachtree Rd NW
Atlanta, GA 30309-1147
Phone (404) 603-8350

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
DN015874GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jett Ferry Dental Group, PC General Practice PastSince Sep 15, 2019 Accepting new patients
Buckhead Dental Center General Practice PastSince May 11, 2025 Accepting new patients

Organizations & group practices 2

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": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1336791391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1469 LIVINGSTON DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300645220",
            "telephone_number": "404-997-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 DUNWOODY CLUB DR STE 105",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303505406",
            "telephone_number": "770-998-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2282 Peachtree Rd NW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303091147",
            "country_code": "US",
            "telephone_number": "404-603-8350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.