Dr. Kissing OB & GYN

Primary specialty

SpecialistTaxonomy code 174400000X

License

64125 Issued in GA

Legal business name

DR. KISSING OB & GYN

Practice address

1860 Duluth Hwy
103
Lawrenceville, GA 30043-5011

Phone

(770) 888-3102

Fax

(770) 212-2188

NPI assigned

Oct 16, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Dominik Kissing, M.D.

Title

Owner

Phone

(770) 888-3102

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Dr Kissing OB GYN3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Dr. Kissing OB & GYN

  • Specialist
  • Norcross, GA
  • NPI 1003244765
  NPD tax ID
• Dr. Kissing OB& GYN

  • Specialist
  • Cumming, GA
  • NPI 1891122677
  NPD tax ID

Locations

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1720416480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 DULUTH HWY",
            "address_2": "103",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435011",
            "telephone_number": "770-888-3102",
            "fax_number": "770-212-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 DULUTH HWY",
            "address_2": "103",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435011",
            "telephone_number": "770-888-3102",
            "fax_number": "770-212-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KISSING OB & GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "KISSING",
        "authorized_official_first_name": "DOMINIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-888-3102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "64125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003112332D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.