Kimathi Pediatric Dentistry PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN013750 Issued in GA

Legal business name

KIMATHI PEDIATRIC DENTISTRY PC

Practice address

3432 Highway 5
Douglasville, GA 30135-2310

Phone

(770) 942-1260

Fax

(770) 942-9244

NPI assigned

May 21, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Travis Kimathi, DDS

Title

President

Phone

(770) 942-1260

Specialties & licenses 1

Addresses

Other names 1

• First Care Pediatric Dentistry Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Bard Heilman, DDS

  • Pediatric Dentistry
  • Douglasville, GA
  • NPI 1508978883
  NPD (past)

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1679833990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3432 HIGHWAY 5",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352310",
            "telephone_number": "770-942-1260",
            "fax_number": "770-942-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3432 HIGHWAY 5",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352310",
            "telephone_number": "770-942-1260",
            "fax_number": "770-942-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMATHI PEDIATRIC DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "KIMATHI",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-942-1260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Care Pediatric Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pediatric Dentistry in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; 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.