DR. ASHISH KUKREJA (NPI# 1447473947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447473947 |
| Entity Type | Individual |
| Full Name | DR. ASHISH KUKREJA |
| Credential | D.D.S. |
| Practice Address |
570 W Lanier Ave Fayetteville GA 30214-7649 |
| Mailing Address |
451 Harold Ave Ne Atlanta GA 30307-1739 |
| Practice Telephone | 6788362128 |
| Practice Fax Number | 7704410299 |
| Mailing Telephone | 5049148748 |
| Mailing Fax Number | 7704410299 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DN013129 | GA | Dental Providers |
| Street Address |
570 W LANIER AVE |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-7649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720182017 | Walter W Reid IIi | Dentist | 570 W Lanier Ave, Bldg #2, Fayetteville, GA 30214-7649 | 2006-09-08 |
| 1932378817 | Julian Christopher White | Dentist | 570 W Lanier Ave, Fayetteville, GA 30214-7649 | 2008-02-26 |
| 1255473401 | George C. Woodrick | Dentist | 570 W Lanier Ave, Fayetteville, GA 30214-7649 | 2007-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952650095 | Ping Seung Alice Wu | Dentist | 2029 Valleygate Dr Ste 201, Fayetteville, NC 28304-3772 | 2012-09-05 |
| 1235355017 | Myra Shivers | Dentist | 118 N Park Dr, Fayetteville, GA 30214-1645 | 2007-04-18 |
| 1417094392 | James M Vlassis | Dentist | 100 N Burdick St, Fayetteville, NY 13066-1319 | 2007-01-31 |
| 1497852495 | Michael Curry | Dentist | 1831 N Green Acres Rd, Fayetteville, AR 72703-2615 | 2006-09-20 |
| 1043584196 | Jeffrey A. Meltzer, D.m.d.,p.c. | Dentist | 516 E Genesee St, Fayetteville, NY 13066-1537 | 2012-03-06 |
| 1346468915 | William Wes Shelton | Dentist | 2001 N Green Acres Rd, Fayetteville, AR 72703-2619 | 2007-04-20 |
| 1780725465 | J. Michael Ruff, Dds, Pa | Dentist | 823 Elm St, Suite 220, Fayetteville, NC 28303-4172 | 2007-02-08 |
| 1346311800 | James Michael Ruff | Dentist | 823 Elm St, Suite 220, Fayetteville, NC 28303-4172 | 2006-11-13 |
| 1053418038 | Northwest Arkansas Periodontal Associates, Pllc | Dentist | 1831 N Green Acres Rd, Fayetteville, AR 72703-2615 | 2006-09-20 |
| 1225135239 | Richard Pierce Osborne II | Dentist | 1831 N Green Acres Rd, Fayetteville, AR 72703-2615 | 2006-09-20 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.