Kennesaw Dental Associates, P,C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN010233 Issued in GA

Legal business name

KENNESAW DENTAL ASSOCIATES, P,C.

Practice address

3600 Cherokee St NW
Suite 117
Kennesaw, GA 30144-2027

Phone

(770) 424-8077

Fax

(770) 499-1929

NPI assigned

May 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. David Eric Olson, DMDNPI 1497176572

Title

President/Owner

Phone

(770) 424-8077

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Eric Olson, D.M.D.

  • General Practice Dentistry
  • Kennesaw, GA
  • NPI 1497176572
  NPD (past) Authorized official

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1972779528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 CHEROKEE ST NW",
            "address_2": "SUITE 117",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442027",
            "telephone_number": "770-424-8077",
            "fax_number": "770-499-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 CHEROKEE ST NW",
            "address_2": "SUITE 117",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442027",
            "telephone_number": "770-424-8077",
            "fax_number": "770-499-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNESAW DENTAL ASSOCIATES, P,C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "770-424-8077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DN010233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamila Ayana Kendall, MD
• Andrea Kennedy, FNP-C
• Emily Kennedy, M.ED.
• Latoya Kenner, MS, BCC
• Kennesaw Acupuncture Clinic
• Kennesaw Health & Wellness
• Kennesaw Health and Wellness
• Kennesaw Health and Wellness Center LLC
• Kennesaw Healthcare Services, LLC
• Kennesaw Luxary Hair Boutique

• Dental Clinic/Center in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.