Healthcare Provider Details

I. General information

NPI: 1184559528
Provider Name (Legal Business Name): KEVIN JOHN EPPES JR. DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FREEDOM WAY
AUGUSTA GA
30904-6258
US

IV. Provider business mailing address

2560 MOORE CROSSING RD
VALDOSTA GA
31606-0677
US

V. Phone/Fax

Practice location:
  • Phone: 229-561-1744
  • Fax:
Mailing address:
  • Phone: 229-561-1744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: