Individual provider Active NPI

Jamar T McKay, DMD

  • General Practice Dentistry
  • Alpharetta, GA
National Provider Identifier
1417422437
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN122867 Issued in GA
Practice address
11770 Haynes Bridge Rd Ste 605
Alpharetta, GA 30009-1971
Phone
(678) 689-0205
NPI assigned
Oct 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN23424 FL
General Practice Dentistry 1223G0001X DN122867 GA Primary

Addresses

Primary practice location

11770 Haynes Bridge Rd Ste 605
Alpharetta, GA 30009-1971

Mailing address

4340 Bluejay PL
Cumming, GA 30041-4770
Phone (954) 470-2524

Other practice location 1

4340 Bluejay Pl
Cumming, GA 30041-4770
Phone (954) 470-2524

Other practice location 2

4340 Bluejay Pl
Cumming, GA 30041-4770
Phone (954) 470-2524

Other practice location 3

1329 E Tennessee St
Tallahassee, FL 32308-5107
Phone (850) 878-7999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20191105000116 FL Order and Referring Only - DentistPractitioner - Dentist 2163754524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN23424FLMDGeneral Practice Dentistry
DN122867GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1417422437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 BLUEJAY PL",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300414770",
            "telephone_number": "954-470-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11770 HAYNES BRIDGE RD STE 605",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091971",
            "telephone_number": "678-689-0205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4340 Bluejay Pl",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300414770",
            "country_code": "US",
            "telephone_number": "954-470-2524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4340 Bluejay Pl",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300414770",
            "country_code": "US",
            "telephone_number": "954-470-2524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1329 E Tennessee St",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323085107",
            "country_code": "US",
            "telephone_number": "850-878-7999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKAY",
        "first_name": "JAMAR",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-05",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23424",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.