Poonam Kalaria

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2405 Satellite Blvd Ste 115
Duluth, GA 30096-9022

Phone

(770) 622-5909

NPI assigned

Apr 14, 2021

Last updated

Oct 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Town Dentistry of Duluth, LLC

  • General Practice Dentistry
  • Duluth, GA
  • NPI 1851163471
  NPD
• Meadowbrook Family Dentistry

  • Dental Clinic/Center
  • Duluth, GA
  • NPI 1295180750
  NPD (past)
• Town Dentistry Brookhaven, LLC

  dba Town Dentistry

  • General Practice Dentistry
  • Brookhaven, GA
  • NPI 1780456301
  NPD (past)
• Town Dentistry Johns Creek, LLC

  • General Practice Dentistry
  • Johns Creek, GA
  • NPI 1588436109
  NPD (past)

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1396326187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 CHATHAM",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307207122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 SATELLITE BLVD STE 115",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300969022",
            "telephone_number": "770-622-5909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3719 Old Alabama Rd Ste 400-B",
            "address_purpose": "LOCATION",
            "city": "Johns Creek",
            "state": "GA",
            "postal_code": "300228692",
            "country_code": "US",
            "telephone_number": "678-250-9511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "804 Town Blvd NE Ste 2010",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "GA",
            "postal_code": "303193147",
            "country_code": "US",
            "telephone_number": "404-631-6277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALARIA",
        "first_name": "POONAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN122813",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaiser Foundation Health Plan of Georgia Inc (Kaiser Permanente Gwinnett Clinic Pharmacy)
• Kaiser Foundation Health Plan of Georgia Inc.
• Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Permanente Gwinnett)
• Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Permanente)
• Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Permanente Gwinnett Home Infusion Retail Pharmacy)
• Brandon Sang Joon Kang, MD
• Emily Mimi Kang
• Hyung Gi Kang, D.C.
• Larry Kang, M.D.
• Rachel J Kang, BCBA

• Student in an Organized Health Care Education/Training Program in Duluth, GA
• Providers in Duluth, GA by specialty
• Student in an Organized Health Care Education/Training Program in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.