Dental Excellence of Kennesaw

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN009592 Issued in GA

Legal business name

DENTAL EXCELLENCE OF KENNESAW

Practice address

2750 Watts Dr NW
Kennesaw, GA 30144-2721

Phone

(770) 429-0955

Fax

(770) 429-0219

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. James Derrick Smith, D.D.S.NPI 1912122961

Title

President

Phone

(770) 429-0955

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• James Derrick Smith, D.D.S.

  • General Practice Dentistry
  • Kennesaw, GA
  • NPI 1912122961
  NPD (past) Authorized official
• Lisa Kirshenbaum, D.M.D.

  • General Practice Dentistry
  • Kennesaw, GA
  • NPI 1114142171
  NPD (past)
• Thomas Edward Shaw III, D.D.S.

  • General Practice Dentistry
  • Kennesaw, GA
  • NPI 1366591166
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710048848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 WATTS DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442721",
            "telephone_number": "770-429-0955",
            "fax_number": "770-429-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 WATTS DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442721",
            "telephone_number": "770-429-0955",
            "fax_number": "770-429-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL EXCELLENCE OF KENNESAW",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "DERRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-429-0955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN009592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Amanda Dellinger, LPC, NCC
• Jennifer Denison, AT-C
• Nicole T. Denman, LPC
• Dennis G Bergin OD
• Hyacinth Dennis-Crooks, NP
• Dental One Associates (Kennesaw) LLC
• Dentfirst PC
• Dentistry at Kennesaw Point
• Donald Douglas Depew, DMD MS PC
• Deriche Agency Inc

• General Practice Dentistry in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.