Barry Kennedy, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

8681 Issued in GA

Practice address

3772 Satellite Blvd
Suite 204
Duluth, GA 30096-5681

Phone

(770) 623-4661

NPI assigned

Mar 14, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932232329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 HITCHING POST LN",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242064",
            "telephone_number": "770-623-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3772 SATELLITE BLVD",
            "address_2": "SUITE 204",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965681",
            "telephone_number": "770-623-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "8681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Thompson Keller, M.A., CADC-II
• Alexa Kelly
• Megan Renee Kelly, M.S., CCC-SLP
• Natalie Kelly
• Kelsey Faith Kempner
• Philip R Kennedy, MD
• Grace Alexandra Kenney, PT, DPT
• Sarah E Kersey
• Keys to a Better Chance Counseling and Consulting, LLC
• Usama Khalid, M.D.

• Periodontics in Duluth, GA
• Providers in Duluth, GA by specialty
• Periodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.