Active NPI
Kathryn Peace Wiggins, RDH
- Dental Hygienist
- Acworth, GA
National Provider Identifier
1376175299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH010143
- Practice address
- 3950 Cobb Pkwy NW Ste 402
Acworth, GA 30101-9528 - Phone
- (770) 966-9396
- NPI assigned
- Feb 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH010143 | GA | Primary |
Addresses
Primary practice location
3950 Cobb Pkwy NW Ste 402
Acworth, GA 30101-9528
Mailing address
81 Pine Grove Rd Apt 12
Cartersville, GA 30120-6462
Phone (404) 445-9364
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
| License | State | Type | Specialty |
|---|---|---|---|
| DH010143 | GA | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Pointe Dental Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Acworth, GA
- NPI 1093825028
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581120000000",
"number": "1376175299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81 PINE GROVE RD APT 12",
"city": "CARTERSVILLE",
"state": "GA",
"postal_code": "301206462",
"telephone_number": "404-445-9364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3950 COBB PKWY NW STE 402",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301019528",
"telephone_number": "770-966-9396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGGINS",
"first_name": "KATHRYN",
"middle_name": "PEACE",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-08",
"last_updated": "2020-02-08",
"certification_date": "2020-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "GA",
"license": "DH010143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Acworth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.