Teresa Marie Decenzo-Verbeten, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001643 Issued in GA

Practice address

11460 Johns Creek Pkwy
Duluth, GA 30097-1518

Phone

(678) 415-3513

Fax

(678) 415-3815

NPI assigned

Jun 14, 2010

Sex

Female

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

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276473600000",
    "number": "1700107729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5135 WILD GINGER CV",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300925145",
            "telephone_number": "678-415-3513",
            "fax_number": "678-415-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11460 JOHNS CREEK PKWY",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300971518",
            "telephone_number": "678-415-3513",
            "fax_number": "678-415-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECENZO-VERBETEN",
        "first_name": "TERESA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2010-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenyatta Victoria Dean, DO
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• Optometrist in Duluth, GA
• Providers in Duluth, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.