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

KALLIE LAW BROCK D.M.D.
NPI 1447596655
Dentist - General Practice in Canton, GA

Active since December 14, 2012PECOS Enrolled
205 WALESKA RD, SUITE 2A, CANTON, GA 30114(770) 479-3713 Get Directions Write a Review

NPPES record last updated: February 15, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kallie Law Brock D.m.d. NPPES

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

KALLIE LAW BROCK D.M.D. (NPI 1447596655) is an individual general practice provider in Canton, Georgia, licensed in South Carolina (8162) and active in the NPI registry since December 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1447596655
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameKALLIE LAW BROCKCredential: D.M.D.
Location Address205 WALESKA RD, SUITE 2ACanton, GA 30114-2493
Mailing Address205 Waleska Rd, Suite 2aCanton, GA 30114-2493 · (770) 479-3713
Phone(770) 479-3713
Sole ProprietorNo
Enumeration DateDecember 14, 2012
Last NPPES UpdateFebruary 15, 2015
✔ NPI 1447596655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in SC · 8162
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Also ListedDentistTaxonomy 122300000X · License DN014538 (GA)
205 WALESKA RD, Canton, GA 30114
Open in Google Maps ↗

Other Names 1

Former Name (1)Kallie Lynn Law D.m.d.

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kallie Law Brock D.m.d. 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 30114 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.

Other Providers at the Same Location NPPES 6

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

NIRALI PROCTER, DMD, LLC
Dentist (General Practice)
205 WALESKA RD
CANTON, GA 30114
Cherokee County (770) 479-1717
DR. JEFFREY MILES MAZZAWI DMD
Dentist (Pediatric Dentistry)
205 WALESKA RD, SUITE 2-B
CANTON, GA 30114
Cherokee County (770) 479-1717
CHEROKEE CHILDREN'S DENTISTRY
Dentist (Pediatric Dentistry)
205 WALESKA RD, SUITE 2B
CANTON, GA 30114
Cherokee County (404) 479-1717
DR. NIRALI PATEL PROCTER DMD
Dentist (General Practice)
205 WALESKA RD, SUITE 2B
CANTON, GA 30114
Cherokee County (770) 479-1717
DR. ANTHEA DREW DMD
Dentist (Pediatric Dentistry)
205 WALESKA RD, SUITE 2-B
CANTON, GA 30114
Cherokee County (404) 275-8443
DR. WILLIAM PAUL EARLY D.C.
Chiropractor
205 WALESKA RD, SUITE 1C
CANTON, GA 30114
Cherokee County (678) 880-7576

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 Kallie Brock's NPI number?

The NPI number for Kallie Brock is 1447596655. It was assigned to this individual provider in the NPPES registry on December 14, 2012. The provider is also known as Kallie Lynn Law D.M.D..

Where is Kallie Brock located?

Kallie Brock practices at 205 Waleska Rd Suite 2A, Canton, GA 30114. The listed phone number is (770) 479-3713.

What is Kallie Brock's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Kallie Brock enrolled in Medicare?

Yes. Kallie Brock is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kallie Brock was last updated on February 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.