Kelly a. Vaughn

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012608 Issued in GA

Legal business name

KELLY A. VAUGHN

Doing business as

Woodstock Dental Care PC

Practice address

9020 Highway 92
Suite 120
Woodstock, GA 30189-3753

Phone

(770) 928-4511

Fax

(770) 928-4310

NPI assigned

Mar 20, 2008

Last updated

Apr 2, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Anita L Falvai

Title

Practice Admin

Phone

(770) 928-4511

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Woodstock Dental Care PC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly Anne Vaughn, DDS

  • General Practice Dentistry
  • Woodstock, GA
  • NPI 1487718177
  NPD (past)

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1770754426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9020 HIGHWAY 92",
            "address_2": "SUITE 120",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301893753",
            "telephone_number": "770-928-4511",
            "fax_number": "770-928-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9020 HIGHWAY 92",
            "address_2": "SUITE 120",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301893753",
            "telephone_number": "770-928-4511",
            "fax_number": "770-928-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY A. VAUGHN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "FALVAI",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE ADMIN",
        "authorized_official_telephone_number": "770-928-4511",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211792479N",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodstock Dental Care PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael G Katopes, M.D.
• KCP Enterprises LLC (Elite Medical and Rehab)
• Anita E Keener, M.ED., CCC-SLP
• Steven J Keith, O.D.
• Joseph M Keller
• Bailey Olivia Kelly, PHARMD
• Benjamin J Kelly, M.D.
• Darlene M Kelsesky, P.T.
• Jason Lee Kelsey, DPT
• Tarsha Chamaine Kennedy, NP-C

• 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 Apr 2, 2012; 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.