Kianna Bloomfield, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN123185 Issued in GA

Practice address

3840 Lavista Rd
Tucker, GA 30084-5142

Phone

(678) 904-6685

NPI assigned

May 8, 2023

Last updated

Aug 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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.

• Atlanta Metro Dental Services, PLLC

  • General Practice Dentistry
  • Lilburn, GA
  • NPI 1992387401
  NPD (past)

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1437849197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 SW 95TH TER",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330251960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 LAVISTA RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845142",
            "telephone_number": "678-904-6685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 7th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352332005",
            "country_code": "US",
            "telephone_number": "205-934-3387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOMFIELD",
        "first_name": "KIANNA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN28367",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN123185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynette Eudora Blackman
• James Blair
• Sarah Blanchard
• Erica L. Bland, MS, CCC-SLP
• Bliss Family Medicine LLC
• Blossom Works Therapy LLC
• Blue Ridge Nutrition Services, Inc.
• Ashley Nicole Boachie-Adjei, PA
• William Boatwright
• Hanif Boghani, MD

• Dentist in Tucker, GA
• Providers in Tucker, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.