Dental One Associates (Kennesaw) LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DENTAL ONE ASSOCIATES (KENNESAW) LLC

Practice address

2616 George Busbee Pkwy NW
Kennesaw, GA 30144-4939

Phone

(770) 421-8821

NPI assigned

Mar 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mike Cole

Title

Insurance Director

Phone

(727) 726-1611

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274054400000",
    "number": "1609909522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 GEORGE BUSBEE PKWY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301444939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 GEORGE BUSBEE PKWY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301444939",
            "telephone_number": "770-421-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ONE ASSOCIATES (KENNESAW) LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2010-05-17",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "INSURANCE DIRECTOR",
        "authorized_official_telephone_number": "727-726-1611"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Denison, AT-C
• Nicole T. Denman, LPC
• Dennis G Bergin OD
• Hyacinth Dennis-Crooks, NP
• Dental Excellence of Kennesaw
• Dentfirst PC
• Dentistry at Kennesaw Point
• Donald Douglas Depew, DMD MS PC
• Deriche Agency Inc
• Annie Derthick, PHD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; 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.