Individual provider Active NPI

Janet Kim Kearns, D.D.S.

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1386713154
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DNO13012 Issued in GA
Practice address
1250 Caroline St NE
Suite C 200
Atlanta, GA 30307-2757
Phone
(404) 889-8370
Fax
(404) 889-8382
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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 DNO13012 GA Primary

Addresses

Primary practice location

1250 Caroline St NE
Suite C 200
Atlanta, GA 30307-2757

Mailing address

1250 Caroline St NE
Suite C 200
Atlanta, GA 30307-2757
Phone (404) 889-8370

Other identifiers 1

IdentifierTypeStateIssuer
122567435AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160531000756 GA Order and Referring Only - Other (Non-Physician) 0749570919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DNO13012GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1386713154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 CAROLINE ST NE",
            "address_2": "SUITE C 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303072757",
            "telephone_number": "404-889-8370",
            "fax_number": "404-889-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 CAROLINE ST NE",
            "address_2": "SUITE C 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303072757",
            "telephone_number": "404-889-8370",
            "fax_number": "404-889-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNS",
        "first_name": "JANET",
        "middle_name": "KIM",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DNO13012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122567435A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.