P Praxis·MD
● Active Type 1 · Individual

DR. Kimberly Brown, DMD

Dentist·Fayetteville, GA· NPI 1720022304 · Enumerated 2006 · 19 years on NPI
Brown is 1 of 48 dentist providers in Fayetteville and 1 of 4309 in Georgia.
NPI age
19 years
Enumerated 2006-06-15
Primary specialty
Dentist
Plus 1 subspecialty
Licensed in
GA, MS
2 states
Status
Active
No deactivations on record
Last NPPES update
2022-06-16
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 4309 active dentist providers in Georgia.

NPI age
19 years
≈ at median (18 yr)
State licenses
2 states
Top 93% — 6% of peers are multi-state
Subspecialties
1
In the 13% of peers with subspecialties

NPI lifetime · 2006 → 2026

2006-06Enumerated in NPPES
2006 2026

Where they practice

Practice location
395 N Jeff Davis Dr Ste A
Fayetteville, GA 302141672
📞 7704600870
Mailing address
102 Hammock Bay Dr
Fayetteville, GA 302157152
📞 6015726808

Additional practice locations

1 secondary location on file with NPPES.

Location 2
3502 W Northside Dr
Jackson, MS 392134454
📞 6013625321fax 6013642600

Specialties

  • Dentist Primary
    A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
    GA license #DN014931 taxonomy 1223G0001X
  • 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...
    MS license #3174 taxonomy 122300000X

Identifiers

TypeValueNotes
05 (MS) 00660404
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.

Practice context

Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.

Recently enumerated nearby: 1 new dentist provider has been added in Fayetteville in the last 180 days. See all →
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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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