1. Home
  2. Directory
  3. Georgia
  4. Marietta
  5. Dentist
  6. NPI Profile

KENNESTONE PERIODONTICS OF MARIETTA, PC
NPI 1316243389
Dentist - Periodontics in Marietta, GA

Active since February 08, 2011
611 CAMPBELL HILL ST NW, SUITE 102, MARIETTA, GA 30060(770) 422-0642(770) 422-0643 Get Directions Write a Review

NPPES record last updated: February 8, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kennestone Periodontics Of Marietta, Pc NPPES

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

KENNESTONE PERIODONTICS OF MARIETTA, PC (NPI 1316243389) is a healthcare organization registered as a periodontics in Marietta, Georgia and active in the NPI registry since February 2011. The organization lists Peter C Shatz, President, as its authorized official.

NPPES Registry Identity

NPI1316243389
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameKENNESTONE PERIODONTICS OF MARIETTA, PC
Location Address611 CAMPBELL HILL ST NW, SUITE 102Marietta, GA 30060-1386
Mailing Address2070 S Park Pl Se, Suite 200Atlanta, GA 30339-2045 · (770) 952-5432 · Fax (770) 952-3011
Phone(770) 422-0642
Fax(770) 422-0643
Organization SubpartNo
Authorized OfficialPeter C ShatzPresident · (770) 422-0642
Enumeration DateFebruary 8, 2011
✔ NPI 1316243389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Licenses✔ Licensed in GA · 10742✔ Licensed in GA · 11384
Definition
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.
611 CAMPBELL HILL ST NW, Marietta, GA 30060
Open in Google Maps ↗

Other Identifiers 2

Other1982798716GA · Personal Npi Number
Other1811082183GA · Personal Npi Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VILLAGE PODIATRY GROUP, P.C.
Podiatrist
611 CAMPBELL HILL ST NW, SUITE 103
MARIETTA, GA 30060
Cobb County (678) 574-0861

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 Kennestone Periodontics Of Marietta, PC's NPI number?

The NPI number for Kennestone Periodontics Of Marietta, PC is 1316243389. It was assigned to this organization in the NPPES registry on February 8, 2011.

Where is Kennestone Periodontics Of Marietta, PC located?

Kennestone Periodontics Of Marietta, PC is located at 611 Campbell Hill St NW Suite 102, Marietta, GA 30060. The listed phone number is (770) 422-0642.

What is Kennestone Periodontics Of Marietta, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

What insurance does Kennestone Periodontics Of Marietta, PC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Kennestone Periodontics Of Marietta, PC 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 Kennestone Periodontics Of Marietta, PC was last updated on February 8, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.