D.KEITH FORTSOND.M.D.P.C. NPI 1033245196

NPI Information

  • NPI: 1033245196
  • Provider Name: D.KEITH FORTSON,D.M.D.,P.C.
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 151 S HARKNESS ST
    JACKSON, GA
    ZIP 30233
  • Phone: (770) 775-4550

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NPI Details

D.KEITH FORTSON,D.M.D.,P.C. is a general practice dentist in Jackson, GA. The provider is 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. D.KEITH FORTSON,D.M.D.,P.C. NPI is 1033245196. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

151 S HARKNESS ST
JACKSON, GA
ZIP 30233-832
Phone: (770) 775-4550
Fax: (770) 775-4338

The provider's authorized official is Dennis Keith Fortson .
The authorized official title is Ceo and has the following contact phone number (770) 775-4550.

The enumeration date for this NPI number is 2/25/2007 and was last updated on 5/29/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeDN008764GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000136694AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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