Individual provider Active NPI

Temilade Oluisa Kadree, DDS

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1942360920
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012889 Issued in GA
Practice address
1014 Ralph David Abernathy Blvd SW
Atlanta, GA 30310-1812
Phone
(404) 755-5555
Fax
(404) 753-1858
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN012889 GA Primary

Addresses

Primary practice location

1014 Ralph David Abernathy Blvd SW
Atlanta, GA 30310-1812

Mailing address

1014 Ralph David Abernathy Blvd SW
Atlanta, GA 30310-1812
Phone (404) 755-5555

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210618000507 GA Order and Referring Only - DentistPractitioner - Dentist 3375943939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN012889GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yanur Associates Inc Past Accepting new patients
Midtown Dental Services, Inc. General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1942360920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 RALPH DAVID ABERNATHY BLVD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101812",
            "telephone_number": "404-755-5555",
            "fax_number": "404-753-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 RALPH DAVID ABERNATHY BLVD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101812",
            "telephone_number": "404-755-5555",
            "fax_number": "404-753-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADREE",
        "first_name": "TEMILADE",
        "middle_name": "OLUISA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.