Individual provider Active NPI

Joshua Kaliher, DMD

  • Dentist
  • Snellville, GA
National Provider Identifier
1740772128
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN123312 Issued in GA
Practice address
1830 Scenic Hwy N Ste 220
Snellville, GA 30078-2100
Phone
(770) 844-9454
NPI assigned
Jun 1, 2018
Reactivated
Apr 24, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10757 TN
Dentist 122300000X DN123312 GA Primary

Addresses

Primary practice location

1830 Scenic Hwy N Ste 220
Snellville, GA 30078-2100

Mailing address

1830 Scenic Hwy N Ste 220
Snellville, GA 30078-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240924000755 GA Order and Referring Only - DentistPractitioner - Dentist 9537600150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN123312GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1740772128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 SCENIC HWY N STE 220",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 SCENIC HWY N STE 220",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782100",
            "telephone_number": "770-844-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIHER",
        "first_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-01",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "deactivation_date": "2021-02-26",
        "reactivation_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "10757",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN123312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.