Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1982626990 Individual Practitioner Male Practitioner

Dr. Kevin Tramon Bolden , DDS

Dentist - General Practice • Austell, GA

Professional Overview & Biography Verified Profile Summary

Dr. Kevin Bolden, DDS is a registered healthcare professional specializing in Dentist - General Practice in Austell, GA. Practice services are available at 780 E WEST CONNECTOR STE 108 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

780 E West Connector Ste 108

Austell, GA 301061349

Telephone 7707027850

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Austell, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
22 Specialists

Practicing in Austell, GA (3302 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-02-03
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License GA DN015352

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License TX 27791

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1507574 (TN)
Medicaid State Provider ID
1513024 (TN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1992227896

Doctor of Dental Medicine

NPI 1992242465

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

18 Historical Events
📍
Updated Practice Location February 03, 2020

Registered at 780 E WEST CONNECTOR STE 108, AUSTELL, GA 301061349 (Tel: 7707027850)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 03, 2020

Dentist (License #DN015352 in GA)

NPI Profile Active September 28, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location September 28, 2017

Registered at 3245 COBB PKWY NW STE 101, ACWORTH, GA 301013949 (Tel: 6782028310)

📍
Updated Business Mailing Address September 28, 2017

Registered at 3805 DALLAS HWY SW STE 806, MARIETTA, GA 300641620 (Tel: (678) 203-3464)

👤
Provider Name / Credentials Updated September 28, 2017

Recorded as KEVIN BOLDEN, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 28, 2017

Dentist (License #DN015352 in GA)

📍
Updated Business Mailing Address June 15, 2017

Registered at 3805 DALLAS HWY SW STE 806, MARIETTA, GA 300641620 (Tel: 6782033464)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 15, 2017

Dentist (License #27791 in TX)

📍
Updated Practice Location May 25, 2017

Registered at 3805 DALLAS HWY SW STE 804, MARIETTA, GA 300641620 (Tel: (678) 203-3464)

📍
Updated Business Mailing Address May 25, 2017

Registered at 3805 DALLAS HWY SW STE 804, MARIETTA, GA 300641620 (Tel: (678) 203-3464)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 25, 2017

Dentist (License #DN015352 in GA)

NPI Profile Active April 29, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location April 29, 2013

Registered at 609 ELM AVE, WACO, TX 76704 (Tel: 2543136960)

📍
Updated Business Mailing Address April 29, 2013

Registered at 1600 PROVIDENCE DR, WACO, TX 767072261 (Tel: 2543134200)

👤
Provider Name / Credentials Updated April 29, 2013

Recorded as KEVIN BOLDEN, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 29, 2013

Dentist (License #27791 in TX)

🟢
Initial NPI Registration & Enumeration July 25, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982626990
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 25, 2006
Last Update: February 03, 2020
Sole Proprietor: No

Mailing Address

3805 Dallas Hwy Sw Ste 806

Marietta, GA 300641620

Phone: 6782033464

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.