DR. KENYATTA VICTORIA DEAN (DO) – Family Medicine Physician, NPI 1710964440
Family Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
3,102 FAMILY PRACTICE in GA
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Provider Addresses for DR. KENYATTA VICTORIA DEAN (DO)
3495, Piedmont Road Northeast, Buckhead, Atlanta, Georgia, 30305, United States
NINE PIEDMONT CENTER
ATLANTA, GA 303059775
Phone: (404) 364-7000
Fax: (404) 364-4732
Type: Mailing
Kaiser Permanente Gwinnett Comprehensive Medical Center, 3650, Steve Reynolds Boulevard, Pleasant Hill, Duluth, Gwinnett County, Georgia, 30096, United States
DEPARTMENT OF INTERNAL MEDICINE TEAM A
DULUTH, GA 300964506
Phone: (770) 931-6011
Type: Location
3495 PIEDMONT RD NE
NINE PIEDMONT CENTER
ATLANTA, GA 303051717
Phone: (404) 364-7000
Fax: (404) 364-4732
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-04-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070410000389 | I | Family Practice | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30305)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | PA | |
| Family Practice | MN | |
| - | GA | |
| - | GA | |
| Family Practice | GA | |
| - | GA | |
| Family Practice | GA | |
| N E U R O L O G Y | GA | |
| Nurse Practitioner | GA | |
| N E U R O L O G Y | IL |
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