Kimberlyn Darlene Fowler, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012322 Issued in GA

Practice address

2040 Eagle Ridge Dr SW
Conyers, GA 30094-3377

Phone

(470) 328-2579

NPI assigned

Mar 1, 2007

Last updated

Sep 19, 2024By 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 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

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1407984412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 EAGLE RIDGE DR SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943377",
            "telephone_number": "470-488-7092",
            "fax_number": "470-489-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 EAGLE RIDGE DR SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943377",
            "telephone_number": "470-328-2579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3539 Wesley Chapel Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300345216",
            "country_code": "US",
            "telephone_number": "770-987-1586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "KIMBERLYN",
        "middle_name": "DARLENE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jemal P Foster
• Lemere Foster
• Paige Bush Foster, O.D.
• John A. Fountain, M.D.
• Olubunmi T Fovie
• Robin J. Fowler, MD
• Ronnette Frank
• Dinah Franklin, M.D.
• Lyndsay Mariah Franklin, RN
• Sonya Franklin

• 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 Sep 19, 2024; 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.