Kenneth David Kligman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9445 Issued in GA

Practice address

113 Towne Lake Pkwy
Suite 110
Woodstock, GA 30188-4853

Phone

(770) 928-3055

Fax

(770) 928-1255

NPI assigned

Mar 26, 2007

Sex

Male

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

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.

• Comprehensive Aesthetic & Restorative Dentistry LLC

  • General Practice Dentistry
  • Woodstock, GA
  • NPI 1023149507
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720106933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 TOWNE LAKE PKWY",
            "address_2": "SUITE 110",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884853",
            "telephone_number": "770-928-3055",
            "fax_number": "770-928-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 TOWNE LAKE PKWY",
            "address_2": "SUITE 110",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884853",
            "telephone_number": "770-928-3055",
            "fax_number": "770-928-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIGMAN",
        "first_name": "KENNETH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Poist Kizzire, PT, DPT
• KJK Compassion Care LLC
• Jacob John Klebar, PT, DPT, CSCS
• Matthew D. Klein, L.P.C.
• Romualda S Klicius, MD
• Tracie Lynn Knauf, MA, CCC-SLP
• Brittany Paris Knight
• Essence Knight
• Sarah Knoblach, OTA
• Helen Bailey Koch, RD, CSP, LD

• General Practice Dentistry in Woodstock, GA
• Providers in Woodstock, 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 Jul 8, 2007; 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.