P Praxis·MD
● Active Type 1 · Individual

DR. Kerisa Harriott, DMD

Dentist·Marietta, GA· NPI 1356607600 · Enumerated 2012 · 14 years on NPI
Harriott is 1 of 24 dentist providers in Marietta and 1 of 526 in Georgia.
NPI age
14 years
Enumerated 2012-04-11
Primary specialty
Dentist
Plus 2 subspecialties
Licensed in
GA, NY
2 states
Status
Active
No deactivations on record
Last NPPES update
2023-07-21
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 526 active dentist providers in Georgia.

NPI age
14 years
↓ 3 yr below median (17 yr)
State licenses
2 states
Top 90% — 9% of peers are multi-state
Subspecialties
1
In the 16% of peers with subspecialties

NPI lifetime · 2012 → 2026

2012-04Enumerated in NPPES
2012 2026

Where they practice

Practice location
1111 Johnson Ferry Rd # 10
Marietta, GA 300682181
📞 7187647479
Mailing address
1512 Justine Way Se
Mableton, GA 301262839
📞 7187647479

Additional practice locations

2 secondary locations on file with NPPES.

Location 2
27005 76th Ave
New Hyde Park, NY 110401402
📞 7187647479
Location 3
1815 Francis Lewis Blvd
Whitestone, NY 113573836
📞 7187468900

Specialties

  • Dentist Primary
    That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and...
    GA license #DN123004NY license #056887 taxonomy 1223X0400X
  • Student in an Organized Health Care Education/Training Program
    An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
    taxonomy 390200000X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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