DR. KENNETH BRADLEY HALL (NPI# 1053358366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053358366 |
| Entity Type | Individual |
| Full Name | DR. KENNETH BRADLEY HALL |
| Credential | DMD |
| Practice Address |
1360 Caduceus Way Bldg 900 Ste 101 Watkinsville GA 30677-7300 |
| Practice Telephone | 7065433629 |
| Practice Fax Number | 7065435107 |
| Mailing Telephone | 7065433629 |
| Mailing Fax Number | 7065435107 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2016-12-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DN012753 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | ZG2753 | 05 | |
| GA | 399593491A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306393079 | Kenneth Hall | Psychiatry & Neurology | 4004 Acton Cir, Birmingham, AL 35243-4202 | 2016-09-09 |
| 1881963585 | Kenneth Walter Hall Jr. | Counselor | 2301 Tremont St, I 407, Philadelphia, PA 19115-5037 | 2011-12-26 |
| 1972675692 | Kenneth Hall | Dentist | 307 West St, Cassville, MO 65625-1538 | 2006-11-15 |
| 1679946172 | Kenneth Hall | Counselor | 4951 Central Ave, Monroe, LA 71203 | 2015-11-05 |
| 1730440264 | Kenneth Hall | Counselor | 995 E 1100 N, American Fork, UT 84003-3226 | 2012-05-31 |
| 1063715399 | Kenneth George Hall | Counselor | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2010-12-08 |
| 1275780124 | Kenneth A. Hall | Social Worker | Madigan Army Medical Ctr, 9040 Reid St., Tacoma, WA 98431-0001 | 2008-08-22 |
| 1821012022 | Kenneth Dale Hall | Pharmacist | 1581 N Main St, Marion, VA 24354-4317 | 2006-07-27 |
| 1831115542 | Kenneth Randall Hall | Optometrist | 383 Sacramento St, San Francisco, CA 94111-3601 | 2006-07-14 |
| 1124025853 | Kenneth Hall | Optometrist | 6828 Bardstown Rd, Louisville, KY 40291-3050 | 2005-07-07 |
| Street Address |
1360 CADUCEUS WAY BLDG 900 STE 101 |
| City | WATKINSVILLE |
| State | GA |
| Zip Code | 30677-7300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275134785 | Ivey Reeves Tenny | Behavioral Analyst | 1360 Caduceus Way, Watkinsville, GA 30677-7300 | 2020-11-03 |
| 1649887639 | Danymarie Baldon Consolacion | Behavior Technician | 1360 Caduceus Way, Watkinsville, GA 30677-7300 | 2020-09-24 |
| 1750906822 | Marissa Evans | Behavior Technician | 1360 Caduceus Way, Building 600-suite 101, Watkinsville, GA 30677 | 2020-06-14 |
| 1962033100 | Savannah Baine | Behavior Technician | 1360 Caduceus Way, Watkinsville, GA 30677-7300 | 2020-01-27 |
| 1679945596 | Athens Cardiac Clinic PC | Internal Medicine | 1360 Caduceus Way, Building 600 Suite 105, Watkinsville, GA 30677-7300 | 2015-10-30 |
| 1013384031 | Aoa Hearing Aids | Audiologist | 1360 Caduceus Way, Building 200, Suite 101, Watkinsville, GA 30677-7300 | 2015-08-25 |
| 1518354018 | Women's Imaging Specialists - Athens, LLC | Clinic/Center | 1360 Caduceus Way, Building 400: Suite 101, Watkinsville, GA 30677-7300 | 2015-04-22 |
| 1356732804 | Athens Digestive Endoscopy Center | Clinic/Center | 1360 Caduceus Way, Building 300, Watkinsville, GA 30677-7300 | 2015-02-05 |
| 1538586516 | Yuca, LLC | Pharmacy | 1360 Caduceus Way, Bldg 400 Suite 105, Watkinsville, GA 30677 | 2014-03-27 |
| 1073891198 | Julio Ernesto Pena | Internal Medicine | 1360 Caduceus Way, Bldg 400, Suite 104, Watkinsville, GA 30677-7300 | 2011-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071478 | Brenda Gerai James | Behavior Technician | 1272 Virgil Langford Rd, Ste 101, Watkinsville, GA 30677 | 2020-10-22 |
| 1881292597 | Chloe Wise | Specialist/Technologist | 360 Caduceus Way Building 600 - Suite 101., Watkinsville, GA 30677 | 2020-10-14 |
| 1912518531 | Samuel S Kwon - Athens Dmd PC | Dentist | 1795 Resurgence Drive, Suite 101, Watkinsville, GA 30677 | 2020-08-17 |
| 1972131977 | Hopebridge LLC | Behavioral Analyst | 1272 Virgil Langford Road, Suite 101, Watkinsville, GA 30677 | 2020-03-27 |
| 1306479068 | Meggan Brittany Reed | Counselor | 1550 Jennings Mill Rd, Suite 1700b, Watkinsville, GA 30677 | 2020-02-20 |
| 1699322040 | Christopher's Bridge, LLC | In Home Supportive Care | 3651 Mars Hill Rd, Suite 1600, Watkinsville, GA 30677 | 2019-08-21 |
| 1093209538 | Haley Bauguss | Physician Assistant | 1624 Mars Hill Road, Suite B, Watkinsville, GA 30677 | 2018-06-19 |
| 1134618317 | Amanda Burns Denson | Nurse Practitioner | 1181 Langford Drive, Building 300, Suite 104, Watkinsville, GA 30677 | 2018-05-03 |
| 1780105528 | Inspiring Hospice Partners of Georgia LLC | Hospice Care, Community Based | 1252 Virgil Langford Rd, Watkinsville, GA 30677 | 2017-07-01 |
| 1750753182 | Zachary Russell | Orthopaedic Surgery | 1305 Jennings Mill Road, Building 300, Suite 110, Watkinsville, GA 30677 | 2015-10-26 |
| Find all providers in zip 30677 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487279055 | Alec Chandler Hall | Dentist | 1180 Resurgence Dr Ste 300, Watkinsville, GA 30677-7211 | 2020-06-10 |
| 1346257748 | James David Brown | Dentist | 1010 Woodlands Rd, Watkinsville, GA 30677-1990 | 2006-08-01 |
| 1962425595 | John S Frantz | Dentist | 1120 Mars Hill Rd, Suite 100, Watkinsville, GA 30677-4800 | 2006-07-25 |
| 1740200344 | Chuck Chambers Dmd | Dentist | 2105 Elder Mill Rd, Watkinsville, GA 30677-3356 | 2006-07-20 |
| 1851779805 | Ronnie Mobley | Dentist | 2281 Hog Mountain Rd, Watkinsville, GA 30677-4846 | 2015-05-11 |
| 1417240979 | Mobley Family Dentistry, Pa | Dentist | 2281 Hog Mountain Rd, Watkinsville, GA 30677-4846 | 2011-05-17 |
| 1376836932 | Rhonda K Mobley | Dentist | 2281 Hog Mountain Rd, Watkinsville, GA 30677-4846 | 2011-05-16 |
| 1912103888 | Ashmita Jayaram Shah | Dentist | 1180 Resurgence Dr, Suite 300, Watkinsville, GA 30677-7210 | 2007-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920445 | Islands Family Dental, LLC | Dentist | 3 Wilmington Village Way, Savannah, GA 31410-3700 | 2020-10-19 |
| 1528665486 | Mount Vernon Dental Group, LLC | Dentist | 2472 Jett Ferry Rd Ste 430, Dunwoody, GA 30338-3059 | 2020-10-05 |
| 1144835570 | Affordable Dentures & Implants of Georgia II, LLC | Dentist | 3675 Satellite Blvd Ste 700, Duluth, GA 30096-2309 | 2020-09-11 |
| 1164037800 | Darby Kathryn Gentry | Dentist | 3585 Lawrenceville Suwanee Rd # 101-a, Suwanee, GA 30024-7058 | 2020-09-10 |
| 1437763380 | Ah Chong | Dentist | 755 Commerce Dr Ste 513, Decatur, GA 30030-2618 | 2020-09-08 |
| 1992319271 | Jillian Nicole Felton | Dentist | 4070 Lavista Rd Ste 102, Tucker, GA 30084-5228 | 2020-09-03 |
| 1295347748 | Elizabeth W Muraya | Dentist | 5218 Jimmy Lee Smith Pkwy Ste 100, Hiram, GA 30141-2747 | 2020-08-17 |
| 1942818182 | Prasanthi Pattabhi | Dentist | 2993 Normandy Rdg, Lawrenceville, GA 30044-7869 | 2020-07-14 |
| 1700404522 | Rocio Jacobo Rubio | Dentist | 23 Old Atlanta Hwy Ste 200, Newnan, GA 30263-6341 | 2020-07-08 |
| 1265059364 | Abboss Sharifzadeh | Dentist | 4090 Jiles Rd Nw, Kennesaw, GA 30144-1105 | 2020-07-06 |
| Find all providers with the same taxonomy | ||||
| City | WATKINSVILLE |
| Zip Code | 30677 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.