Jeffery Alan Kendrick, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN011699 Issued in GA

Practice address

171 Price Rd
Fayetteville, GA 30215-2016

Phone

(770) 460-9795

Fax

(770) 460-7536

NPI assigned

Jul 28, 2006

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.

• John K Kendrick DMD PC

  • General Practice Dentistry
  • Fayetteville, GA
  • NPI 1578665881
  NPD (past) Authorized official

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1477567295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-460-9795",
            "fax_number": "770-460-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 PRICE RD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152016",
            "telephone_number": "770-460-9795",
            "fax_number": "770-460-7536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 Hwy 314",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "30214",
            "country_code": "US",
            "telephone_number": "770-460-9795",
            "fax_number": "770-460-7536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "JEFFERY",
        "middle_name": "ALAN",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Keith, NP
• John A Keller, MD
• Pamela Kelley, NP-C
• Ashlei Henderson Kelly, PT, DPT
• Louise Kelly, LAPC
• Shanithia Kendrick, LPC
• Anne Kennedy, M.A, BCBA
• Callie Kennedy
• Danna-Grace Kennedy, PA
• Dominique Yvette Kennedy, SLP

• General Practice Dentistry in Fayetteville, GA
• Providers in Fayetteville, 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 Nov 25, 2019; 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.