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General NPI Number Information
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NPI Number | 1871486589
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Entity Type | Individual
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Provider Name | KEVIN PRASHAD DMD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 920 LOGANVILLE HWY STE 100
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City | BETHLEHEM
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State | GA
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Zip | 30620-2164
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Country | US
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Telephone | 706-447-9903
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Fax |
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Provider Business Mailing Address
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Address Line | 3189 HIGHWAY 78
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City | LOGANVILLE
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State | GA
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Zip | 30052-3743
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 123927
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License Number State | GA
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