KANISHA SMITH
NPI 1043953151
Dentist in Conyers, GA

Q: What is Kanisha Smith's NPI number?

The NPI number for Kanisha Smith is 1043953151. It was assigned to this individual provider in the NPPES registry on April 16, 2022.

Q: What is Kanisha Smith's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Kanisha Smith was last updated on July 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 16, 2022PECOS Enrolled

2390 WALL ST SE STE 120, CONYERS, GA 30013(770) 929-3411 Get Directions Write a Review

NPPES record last updated: July 28, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 28, 2023, Apr 16, 2022 (2 updates tracked since 2022).

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About Kanisha Smith NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KANISHA SMITH (NPI 1043953151) is an individual dentist in Conyers, Georgia, licensed in Georgia (DN123200) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043953151

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameKANISHA SMITH

Location Address2390 WALL ST SE STE 120Conyers, GA 30013-2151

Mailing Address2390 Wall St Se Ste 120Conyers, GA 30013-2151

Phone(770) 929-3411

Sole ProprietorNo

Enumeration DateApril 16, 2022

Last NPPES UpdateJuly 28, 20232 updates tracked since enumeration

NPPES CertifiedJuly 27, 2023

✔ NPI 1043953151 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Licenses✔ Licensed in GA · DN123200✔ Licensed in MO · 2022024407

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

2390 WALL ST SE STE 120, Conyers, GA 30013

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kanisha Smith is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30013 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kanisha Smith's NPI number?

The NPI number for Kanisha Smith is 1043953151. It was assigned to this individual provider in the NPPES registry on April 16, 2022.

Where is Kanisha Smith located?

Kanisha Smith practices at 2390 Wall St SE Ste 120, Conyers, GA 30013. The listed phone number is (770) 929-3411.

What is Kanisha Smith's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Kanisha Smith enrolled in Medicare?

Yes. Kanisha Smith is registered in the Medicare PECOS enrollment system.

What insurance does Kanisha Smith accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 3 other insurers list Kanisha Smith as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kanisha Smith was last updated on July 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.