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

NPI Status: Active since February 08, 2011

Contact Information

611 CAMPBELL HILL ST NW
SUITE 102
MARIETTA, GA
ZIP 30060
Phone: (770) 422-0642
Fax: (770) 422-0643

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  • Organization
  • Dentist
  • Periodontics
  • Accepts Insurance

About KENNESTONE PERIODONTICS OF MARIETTA, PC

This page provides the complete NPI Profile along with additional information for Kennestone Periodontics Of Marietta, Pc, a provider established in Marietta, Georgia operating as a Dentist, focusing in periodontics . The healthcare provider is registered in the NPI registry with number 1316243389 assigned on February 2011. The practitioner's primary taxonomy code is 1223P0300X with license number 10742 (GA). The provider is registered as an organization and their NPI record was last updated 15 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Peter C Shatz Dds (President)

NPI
1316243389
Provider Name
KENNESTONE PERIODONTICS OF MARIETTA, PC
Entity Type
Organization
Location Address
611 CAMPBELL HILL ST NW SUITE 102 MARIETTA, GA 30060
Location Phone
(770) 422-0642
Location Fax
(770) 422-0643
Mailing Address
2070 S PARK PL SE SUITE 200 ATLANTA, GA 30339
Mailing Phone
(770) 952-5432
Mailing Fax
(770) 422-0643
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-08-2011
Last Update Date
02-08-2011
Code Navigator

A dentist like Kennestone Periodontics Of Marietta, Pc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist Periodontics

Taxonomy Code
1223P0300X
Type
Dental Providers
License No.
10742
License State
GA
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
11223P0300XDental Providers

Dentist
Periodontics

11384 (GA)

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clarity Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Lone Star - Smile Now - PPO
  • Smile Now Arizona - No Waiting Period PPO - PPO
  • Smile Now Michigan - No Waiting Period PPO - PPO
  • Smile Now Ohio - No Waiting Period PPO - PPO
  • Smile Now Texas- No Waiting Period Plan - PPO
  • Smile Now Utah - No Waiting Period PPO - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. PETER C SHATZ DDS

Authorized Official Title
PRESIDENT
Authorized Official Phone
(770) 422-0642

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1982798716OTHER (01)GAPERSONAL NPI NUMBER
1811082183OTHER (01)GAPERSONAL NPI NUMBER

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1316243389, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
1
Doubled → 2
Pos 4
6
Unchanged
Pos 5
2
Doubled → 4
Pos 6
4
Unchanged
Pos 7
3
Doubled → 6
Pos 8
3
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 2 → 4 3 → 6 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 2 + 6 + 4 + 4 + 6 + 3 + 1 + 6 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1316243389.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Dentist (General Practice)
611 CAMPBELL HILL ST NW, SUITE 101
MARIETTA, GA 30060
Podiatrist
611 CAMPBELL HILL ST NW, SUITE 103
MARIETTA, GA 30060

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316243389, enumerated as an "organization" on February 08, 2011.

The provider is located at 611 CAMPBELL HILL ST NW SUITE 102 MARIETTA, GA 30060 and the phone number is (770) 422-0642.

Dentist with taxonomy code 1223P0300X and a focus in Periodontics.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter. Please consult your insurance carrier or call the provider to verify.