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Deactivated NPI 1669548566 Deactivated / Inactive NPI Male Practitioner

Dr. Stephen Reynolds Connelly , DMD

Dentist - General Practice • Marietta, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Stephen Connelly has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 24, 2006
NPI Deactivation Date December 05, 2022
Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Stephen Connelly, DMD was a registered Dentist - General Practice practicing in Marietta, GA. Throughout an active medical career spanning 16 years, Dr. Connelly provided care at the practice location at 1070 WOODLAWN DR NE STE 100 until profile deactivation on 2022-12-05.

Practice Location & Contact Primary Location

Practice Address

1070 Woodlawn Dr Ne Ste 100

Marietta, GA 300684290

Telephone 7709777600
Fax 7709776819
Associated Practice Facility / Clinic
🏢 Perimeter Dental East Cobb Facility NPI 1093423253

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Marietta, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.0 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
162 Specialists

Practicing in Marietta, 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

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License GA DN012748

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.

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated December 05, 2022

Record deactivated on December 05, 2022

NPI Profile Active March 23, 2016

NPI status registered as active in NPPES database

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Updated Practice Location March 23, 2016

Registered at 1070 WOODLAWN DR NE STE 100, MARIETTA, GA 300684290 (Tel: 7709777600)

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Updated Business Mailing Address March 23, 2016

Registered at 1070 WOODLAWN DR NE STE 100, MARIETTA, GA 300684290 (Tel: 7709777600)

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Provider Name / Credentials Updated March 23, 2016

Recorded as STEPHEN CONNELLY, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 23, 2016

Dentist (License #DN012748 in GA)

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Initial NPI Registration & Enumeration November 24, 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: 1669548566
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 24, 2006
Last Update: March 23, 2016
Deactivation Date: December 05, 2022

Mailing Address

1070 Woodlawn Dr Ne Ste 100

Marietta, GA 300684290

Phone: 7709777600

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.