Provider Demographics
NPI:1417422437
Name:MCKAY, JAMAR T (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMAR
Middle Name:T
Last Name:MCKAY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 BLUEJAY PL
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-4770
Mailing Address - Country:US
Mailing Address - Phone:954-470-2524
Mailing Address - Fax:
Practice Address - Street 1:11770 HAYNES BRIDGE RD STE 605
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1971
Practice Address - Country:US
Practice Address - Phone:678-689-0205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN234241223G0001X
GADN1228671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice