Organization Active NPI

Kerisa Harriott DMD P.C.

Doing business as RenewALL Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Smyrna, GA
National Provider Identifier
1851199616
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
KERISA HARRIOTT DMD P.C.
Doing business as
RenewALL Orthodontics
Practice address
4500 West Village PL SE Suite 2011
Smyrna, GA 30080-9243
Phone
(770) 696-6762
NPI assigned
Mar 6, 2025
Last updated
Mar 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Authorized official

Name
Dr. Kerisa Harriott, DMDNPI 1356607600
Title
President/Orthodontist
Phone
(770) 696-6762

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU Primary

Addresses

Primary practice location

4500 West Village PL SE Suite 2011
Smyrna, GA 30080-9243

Mailing address

4500 West Village PL SE Suite 2011
Smyrna, GA 30080-9243
Phone (770) 696-6762

Other identifiers 1

IdentifierTypeStateIssuer
1356607600OtherGAINDIVIDUAL NPI

Other names 1

  • RenewALL Orthodontics Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741219200000",
    "number": "1851199616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 WEST VILLAGE PL SE SUITE 2011",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300809243",
            "telephone_number": "770-696-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 WEST VILLAGE PL SE SUITE 2011",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300809243",
            "telephone_number": "770-696-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERISA HARRIOTT DMD P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A",
        "authorized_official_last_name": "HARRIOTT",
        "authorized_official_first_name": "KERISA",
        "authorized_official_title_or_position": "PRESIDENT/ORTHODONTIST",
        "authorized_official_telephone_number": "770-696-6762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1356607600",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RenewALL Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.