DR. KENNETH RAY COLLINS JR. (NPI# 1114006020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114006020 |
| Entity Type | Individual |
| Full Name | DR. KENNETH RAY COLLINS JR. |
| Credential | D.D.S. |
| Practice Address |
100 Carnegie Pl Suite 108 Fayetteville GA 30214-3905 |
| Practice Telephone | 7704610188 |
| Practice Fax Number | 7704610488 |
| Mailing Telephone | 7704610188 |
| Mailing Fax Number | 7704610488 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
012476 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588130736 | Kenneth P Collins | Pharmacist | 106 Jason Dr, Butler, PA 16002-9086 | 2018-10-15 |
| 1821128190 | Kenneth M Collins | Dentist | 1841 1st St, Cheney, WA 99004-1966 | 2007-03-06 |
| 1679504906 | Kenneth Patrick Collins | Urology | 2750 Clay Edwards Dr Ste 500, North Kansas City, MO 64116-3258 | 2006-07-05 |
| 1679571723 | Kenneth Paul Collins | Family Medicine | 520 N Spring St, Harrison, AR 72601-3528 | 2005-07-12 |
| 1427603794 | Kenneth Victor Collins | Nurse Practitioner | 1201 Fairmount Ave, Fort Worth, TX 76104-4215 | 2019-08-05 |
| 1154974558 | Kenneth Roy Collins | Social Worker | 1191 Nw Tahoe Ln, Silverdale, WA 98383-7954 | 2019-07-24 |
| 1366812414 | Kenneth Collins | Counselor | 9826 18th Ave, Blythe, CA 92225-9229 | 2015-10-01 |
| 1922308170 | Kenneth Collins | Occupational Therapist | 711 Avignon Dr, Ridgeland, MS 39157-5120 | 2010-10-21 |
| 1679759880 | Kenneth Christopher Collins | Clinical Nurse Specialist | 1033 Dr Martin Luther King Jr St N, Suite 108, St Petersburg, FL 33701-1547 | 2008-01-17 |
| 1114062593 | Kenneth J Collins Jr. | Dentist | 3151 E 28th Ave, Spokane, WA 99223-4922 | 2007-02-21 |
| Street Address |
100 CARNEGIE PL SUITE 108 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-3905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689031023 | Thomas A. Sarna Dds,pllc | Dentist | 3533 North Shiloh Drive Suite 3, Fayetteville, AR 72703 | 2016-01-15 |
| 1518232727 | Matthew Mcshane | Dentist | 163 Van Ashe Loop, Fayetteville, AR 72703 | 2012-03-21 |
| 1326345323 | Patton Mark Minkin | Dentist | 3996 N Frontage Rd, Fayetteville, AR 72703 | 2011-02-28 |
| 1568693877 | Jeffrey E Aycock | Dentist | 1031 Weiss Ave Ste 201, Fayetteville, NC 28305-5630 | 2009-08-04 |
| 1144342007 | Sylvester Own Smith IIi | Dentist | 1417 Fort Bragg Road, Fayetteville, NC 28305-4707 | 2007-04-04 |
| 1881710945 | Joshua Russell Cross | Dentist | 163 W Van Asche Loop, Fayetteville, AR 72703-4974 | 2007-03-21 |
| 1083772438 | Richard Clayton Adams | Dentist | 413 Owens Drive, Suite 102, Fayetteville, NC 28304 | 2006-12-05 |
| 1518037076 | James Buck Hays | Dentist | 2025 N Green Acres Rd, Fayetteville, AR 72703-2619 | 2006-11-09 |
| 1275618019 | Vitkus and Scutari Dds, PC | Dentist | 516 E Genesee St, Fayetteville, NY 13066-1537 | 2006-10-26 |
| 1730272402 | Dale A Childers | Dentist | 2409 Robeson Street, Fayetteville, NC 28305 | 2006-10-02 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on DR. KENNETH RAY COLLINS JR..
| 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.