Active NPI
David Glenn Kemp, D.D.S.
- Dentist
- Flowery Branch, GA
National Provider Identifier
1538167069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 014012
- Practice address
- 4030 Winder Hwy
Flowery Branch, GA 30542-3021 - Phone
- (678) 960-3440
- Fax
- (678) 960-3445
- NPI assigned
- Jul 8, 2005
- Last updated
- Jan 18, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 014012 | GA | Primary |
Addresses
Primary practice location
4030 Winder Hwy
Flowery Branch, GA 30542-3021
Mailing address
4030 Winder Hwy
Flowery Branch, GA 30542-3021
Phone (678) 960-3440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014012 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Dental Professionals, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Austell Family Dental Care
- General Practice Dentistry
- Austell, GA
- NPI 1144691684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484697600000",
"number": "1538167069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4030 WINDER HWY",
"city": "FLOWERY BRANCH",
"state": "GA",
"postal_code": "305423021",
"telephone_number": "678-960-3440",
"fax_number": "678-960-3445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4030 WINDER HWY",
"city": "FLOWERY BRANCH",
"state": "GA",
"postal_code": "305423021",
"telephone_number": "678-960-3440",
"fax_number": "678-960-3445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEMP",
"first_name": "DAVID",
"middle_name": "GLENN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-08",
"last_updated": "2017-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "014012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flowery Branch, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.