Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kanisha Smith

Individual provider Dentist · NPI 1043953151

Kanisha Smith is a Dentist in Conyers, Georgia. Licensed in Georgia and Missouri. Registered with an NPI since 2022.

Licensed in
GA, MO
In the registry since
2022
Specialties on file
2

Practice location Address checks out

2390 Wall St SE Ste 120
Conyers, GA 30013-2151
Phone: (770) 929-3411
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DN123200 (GA)
Dentist Taxonomy 122300000X · Licence 2022024407 (MO)

Record details

NPI number1043953151
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 16, 2022
Last updated in NPPESJuly 28, 2023
Certification dateJuly 27, 2023
Mailing address2390 Wall St Se Ste 120, Conyers, GA 30013-2151

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