Kenneth Desmond Bunn, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN014435 Issued in GA

Practice address

9579 Highway 5 Ste 701
Douglasville, GA 30135-1574

Phone

(770) 942-2852

NPI assigned

Jul 10, 2012

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

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 and National Provider Directory roles.

• Douglasville Dental Associates, P.C.

  • General Practice Dentistry
  • Douglasville, GA
  • NPI 1639353964
  NPD (past)

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1447515093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9579 HIGHWAY 5 STE 701",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351574",
            "telephone_number": "770-942-2852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9579 HIGHWAY 5 STE 701",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351574",
            "telephone_number": "770-942-2852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNN",
        "first_name": "KENNETH",
        "middle_name": "DESMOND",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-10",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosalind Buckner
• Tri Bui, RPH
• Cory Buice, DPT
• Raeonda Bullard, MD
• William G Bumgarner, DDS
• Gina Marie Burbank, FNP-C
• Jessica Burger, RBT
• Gabrielle Marie Burholt, MA, NCC, LAPC
• Christopher Michael Burket, MD
• Cassaundra A Burks, DA,CPC,PCT,DH,MA,CET

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.