Cornelius Homer Daniel, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN015921 Issued in GA

Practice address

2239 Highway 20 SE Ste H
Conyers, GA 30013-2087

Phone

(770) 921-3565

Fax

(770) 921-3534

NPI assigned

Jul 10, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

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.

• Conyers Smiles Dentistry, PC

  • General Practice Dentistry
  • Conyers, GA
  • NPI 1255734174
  NPD (past)

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1396397386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 HALEYS WAY SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136445",
            "telephone_number": "404-216-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 HIGHWAY 20 SE STE H",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132087",
            "telephone_number": "770-921-3565",
            "fax_number": "770-921-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "CORNELIUS",
        "middle_name": "HOMER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Diane Daffin
• Ernetta Dailey-Worthy
• Daily Haven Inc.
• Daisy Women'S Center & OB Urgent Care
• Vanessa L. Dameron, RRT
• Laurie Daniel
• Trevor Daniel
• Etoyus Daniels, APRN
• Tamara L Daniels
• Tricia Daniels

• General Practice Dentistry in Conyers, GA
• Providers in Conyers, 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 Jul 10, 2019; 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.