Active NPI
Kyle John Emer, DMD
- General Practice Dentistry
- Kennesaw, GA
National Provider Identifier
1760009302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN016093
- Practice address
- 6110 Pine Mountain Rd NW Ste 101
Kennesaw, GA 30152-3335 - Phone
- (770) 426-0503
- NPI assigned
- Jun 30, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN016093 | GA | Primary |
Addresses
Primary practice location
6110 Pine Mountain Rd NW Ste 101
Kennesaw, GA 30152-3335
Mailing address
1310 Cobblemill Way NW
Kennesaw, GA 30152-5200
Phone (770) 851-3190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN016093 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johnson Ferry Dentistry, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Marietta, GA
- NPI 1275967663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1760009302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 COBBLEMILL WAY NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301525200",
"telephone_number": "770-851-3190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6110 PINE MOUNTAIN RD NW STE 101",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301523335",
"telephone_number": "770-426-0503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMER",
"first_name": "KYLE",
"middle_name": "JOHN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-30",
"last_updated": "2023-08-21",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN016093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.