Kennestone North Dental Associates

Primary specialty

DentistTaxonomy code 122300000X

License

9133 Issued in GA

Legal business name

KENNESTONE NORTH DENTAL ASSOCIATES

Practice address

840 Church St
Building E
Marietta, GA 30060

Phone

(770) 422-7673

Fax

(770) 422-1478

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Steven Dale Adkisson, DMDNPI 1912240094

Title

President

Phone

(770) 442-7673

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Steven Dale Adkisson, DMD

  • Dentist
  • Marietta, GA
  • NPI 1912240094
  NPD (past) Authorized official

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760547772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 CHURCH ST",
            "address_2": "BUILDING E",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-422-7673",
            "fax_number": "770-422-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 CHURCH ST",
            "address_2": "BUILDING E",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-422-7673",
            "fax_number": "770-422-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNESTONE NORTH DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ADKISSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-442-7673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "9133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennestone Hospital, Inc.
• Kennestone Hospital, Inc.
• Kennestone Internal Medicine Associates PC
• Kennestone Medical Inc.
• Kennestone Neurology Associates, P.C.
• Kennestone Periodontics of Marietta, PC
• Kenneth C Molkner MD PC
• Kenneth O Logan, D.C.,P.C.
• Patricia Anne Kennington, PH.D.
• Kennstar LLC

• Dentist in Marietta, GA
• Providers in Marietta, GA by specialty
• Dentist 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.