Organization Active NPI

Jeff L. Rodgers, DMD, PC

  • Customized Equipment (DME)
  • Kennesaw, GA
National Provider Identifier
1922982388
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
JEFF L. RODGERS, DMD, PC
Practice address
1690 Stone Village LN NW Ste 1000
Kennesaw, GA 30152-7714
Phone
(770) 288-5991
NPI assigned
Jul 31, 2025
Last updated
Jul 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Cathy Daly
Title
Office Manager
Phone
(770) 394-4310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

1690 Stone Village LN NW Ste 1000
Kennesaw, GA 30152-7714

Mailing address

1719 Mount Vernon Rd
Dunwoody, GA 30338-4268
Phone (770) 394-4310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201208000102 GA Part B Supplier - Clinic/Group Practice 7012142128 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dunwoody, GA; Kennesaw, GA
O20260415001674 GA DME Supplier - Oral Surgery - Dentist 7012142128 Practice locations: Kennesaw, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jeff L Rodgers DMD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1690 Stone Village Ln NW
Ste 1000
Kennesaw, GA 30152
Phone (770) 288-5991

1690 Stone Village Ln NW
Ste 1001
Kennesaw, GA 30152
Phone (770) 288-5991

Practitioners & affiliated clinicians

Practitioners 2

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": "1753920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1922982388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 MOUNT VERNON RD",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303384268",
            "telephone_number": "770-394-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 STONE VILLAGE LN NW STE 1000",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527714",
            "telephone_number": "770-288-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF L. RODGERS, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-31",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "DALY",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-394-4310"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "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 Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.