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

MS. Dereka McKissack McKissack

Individual provider Dental Assistant · NPI 1124469705

MS. Dereka McKissack McKissack is a Dental Assistant in Stone Mountain, Georgia. Practices as a sole proprietor. Registered with an NPI since 2013.

In the registry since
2013

Practice location Address checks out

374 N Deshon Rd Ste D
Stone Mountain, GA 30087-4827
Phone: (770) 469-4192
Fax: (770) 469-4195
Show map & directions

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

Specialties & licences

Dental Assistant (primary) Taxonomy 126800000X

Record details

NPI number1124469705
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 11, 2013
Last updated in NPPESJuly 11, 2013