Kristine Mycroft, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN015667 Issued in GA

Practice address

2175 North Rd
Snellville, GA 30078-2630

Phone

(770) 284-9171

NPI assigned

Jun 18, 2018

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jasper Dental Associates, P.C.

  • General Practice Dentistry
  • Jasper, GA
  • NPI 1356074363
  NPD (past)

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694304000000",
    "number": "1972097541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 HUTCH LN",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 NORTH RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782630",
            "telephone_number": "770-284-9171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "938 W Church St",
            "address_purpose": "LOCATION",
            "city": "Jasper",
            "state": "GA",
            "postal_code": "301431496",
            "country_code": "US",
            "telephone_number": "706-862-1769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYCROFT",
        "first_name": "KRISTINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2023-09-10",
        "certification_date": "2023-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bailey Murry
• William Musarra, A.A.
• James Murigu Mwangi, MD
• My House Inc
• My Mobility Ride
• Breeona N Myers
• Nadia Najam, CPNP-PC
• Nafeesah Najieb
• Masaki Nakamura
• Tiffany Nance

• General Practice Dentistry in Snellville, GA
• Providers in Snellville, 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 Sep 10, 2023; 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.