Dolly Chanta'E Penn, MD, MSCR

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

81812 Issued in GA

Practice address

111 Mountain Brook Dr Ste 100
Canton, GA 30115-9045

Phone

(678) 880-9654

NPI assigned

Jun 18, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dolly Penn White Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Bethesda Community Clinic Inc

  • Community Health Nurse Practitioner
  • Ball Ground, GA
  • NPI 1215621701
  NPD (past)
• Summit Medical Group, Inc

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  NPD (past)

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1669609442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6707 DEMOCRACY BLVD SUITE 800",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208925465",
            "telephone_number": "301-496-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MOUNTAIN BROOK DR STE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159045",
            "telephone_number": "678-880-9654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Metropolitan Ct Ste 1",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208784016",
            "country_code": "US",
            "telephone_number": "240-773-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENN",
        "first_name": "DOLLY",
        "middle_name": "CHANTA'E",
        "credential": "MD, MSCR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "81812",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MD",
            "license": "D81335",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "GA",
            "license": "81812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PracticeFusion",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "111 Mountain Brook Dr Ste 100",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301159045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DOLLY",
            "last_name": "WHITE",
            "middle_name": "PENN",
            "credential": "MD, MSCR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John David Peacock, DDS, FAGD
• Christopher Peel, PHARMD
• Sarah Turner Peele, RD
• Carolyn Pellegrino, MS, CCC-SLP
• Hannah Penaluna, RM
• Karen M Pennelli, P.A
• Manuel R Peralta
• Carolyn Perilli, RN
• Perimeter Anesthesia LLC
• William Bradford Perry, PHARM.D.

• All providers in Canton, GA
• Public Health & General Preventive Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.