What is Dereka Mckissack's NPI number?

Dereka Mckissack's National Provider Identifier (NPI) is 1124469705, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Dereka Mckissack's specialty?

Dereka Mckissack is listed in the NPPES registry with a primary specialty of Dental Assistant (Dental Providers).

Where is Dereka Mckissack located?

Dereka Mckissack's practice location on file with NPPES is 374 N Deshon Rd Ste D, Stone Mountain, GA 30087-4827.

What is Dereka Mckissack's phone number?

The practice phone number listed in the NPPES registry for Dereka Mckissack is (770) 469-4192.

Is Dereka Mckissack's NPI active?

Yes — Dereka Mckissack's NPI (1124469705) is active in the NPPES registry as of the last update on 2013-07-11.

IndividualActive

Dereka Mckissack

NPI 1124469705 · Dental Assistant · Stone Mountain, GA

Dereka Mckissack is a Dental Assistant provider in Stone Mountain, GA (NPI 1124469705).

Provider details

NPI number: 1124469705
Entity type: Individual
Primary specialty: Dental AssistantDental Providers
Sex: Female
Sole proprietor: Yes

Specialties & taxonomies

Dental AssistantPrimary126800000X
Dental Providers

Profile Score

Established profile(71/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
13 yrs in NPPES registry
Profile completeness38% of score
83% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

374 N Deshon Rd Ste D

Stone Mountain, GA 30087-4827

Phone: (770) 469-4192

Fax: (770) 469-4195

Street-level locationGet directions

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Mailing address