OrganizationActive
Kennestone Periodontics of Marietta, PC
NPI 1316243389 · Periodontics · Marietta, GA
Kennestone Periodontics of Marietta, PC is a Periodontics organization in Marietta, GA (NPI 1316243389).
Provider details
- NPI number
- 1316243389
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Peter Shatz, President(770) 422-0642
- License
- 11384 (GA)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% 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
611 Campbell Hill St Nw
Suite 102
Marietta, GA 30060-1386
Phone: (770) 422-0642
Fax: (770) 422-0643
Street-level locationGet directions
Mailing address
2070 S Park Pl Se
Atlanta, GA 30339-2045
Registry dates
- Enumerated
- 2011-02-08
- Last updated
- 2011-02-08
Frequently asked questions
- What is Kennestone Periodontics of Marietta, PC's NPI number?
- Kennestone Periodontics of Marietta, PC's National Provider Identifier (NPI) is 1316243389, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kennestone Periodontics of Marietta, PC?
- Kennestone Periodontics of Marietta, PC is classified in the NPPES registry as Periodontics (Dental Providers).
- Where is Kennestone Periodontics of Marietta, PC located?
- Kennestone Periodontics of Marietta, PC's practice location on file with NPPES is 611 Campbell Hill St Nw, Marietta, GA 30060-1386.
- What is Kennestone Periodontics of Marietta, PC's phone number?
- The practice phone number listed in the NPPES registry for Kennestone Periodontics of Marietta, PC is (770) 422-0642.
- Who is the authorized official for Kennestone Periodontics of Marietta, PC?
- The authorized official listed on Kennestone Periodontics of Marietta, PC's NPPES record is Peter Shatz, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kennestone Periodontics of Marietta, PC's NPI active?
- Yes — Kennestone Periodontics of Marietta, PC's NPI (1316243389) is active in the NPPES registry as of the last update on 2011-02-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.