Canton Smiles Dentistry, PC

Dentist in Canton, GA. Organization (NPI-2).

NPI number1093149486

StatusActive

Last updated in NPPESAug 21, 2013

Details

NPI: 1093149486
Entity type: Organization (NPI-2)
Legal business name: Canton Smiles Dentistry, PC
Organization subpart: No
Enumeration date: Aug 21, 2013
Last updated: Aug 21, 2013

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
122300000X	Dentist	–	–	Yes

Other names

Canton Smiles Dentistry (Doing Business As)

Practice location

1425 Riverstone Pkwy Ste 200
Canton, GA 30114-5611

Phone 770-479-0600 · Fax 770-479-0599

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626

Phone 714-845-8890 · Fax 949-474-1495

Authorized official

David G Kemp
Owner Doctor
7704790600

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dentist providers in Canton, GA

All 29 Dentist providers in Canton · All 1,795 providers in Canton

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