Active NPI
Jamar T McKay, DMD
- General Practice Dentistry
- Alpharetta, GA
National Provider Identifier
1417422437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN122867
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191105000116 | FL | Order and Referring Only - Dentist | 2163754524 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN23424 | FL | MD | General Practice Dentistry |
| DN122867 | GA | MD | General 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.