Kanisha Smith

Dentist · Conyers, GA

Individual Active NPI

NPI number 1043953151

Practice location

2390 Wall St SE Ste 120
Conyers, GA 30013-2151
Phone
(770) 929-3411

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NPI record

NPI
1043953151
Entity type
Individual (Type 1)
Enumeration date
April 16, 2022
Last updated
July 28, 2023
Certified
July 27, 2023
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X DN123200 GA
Dentist 122300000X 2022024407 MO

About Kanisha Smith

Kanisha Smith is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 2390 Wall St SE Ste 120, Conyers, GA 30013-2151. The NPI number 1043953151 was assigned on April 16, 2022 and the record was last updated on July 28, 2023.

Kanisha Smith lists 2 licenses in the registry: #DN123200 (GA) for Dentist; #2022024407 (MO) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kanisha Smith?

The NPI number is 1043953151.

What is the phone number of Kanisha Smith?

The phone number listed for the practice location is (770) 929-3411.

Where is Kanisha Smith located?

2390 Wall St SE Ste 120, Conyers, GA 30013-2151.

What is the taxonomy code for Kanisha Smith?

The primary taxonomy code is 122300000X – Dentist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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