John R Kelly in Port Matilda - Pediatric Dentistry
John R Kelly - NPI 1861615569
John R Kelly is a Pediatric Dentistry in Port Matilda, Pennsylvania. John R Kelly practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for John R Kelly is 1861615569. The last update date is 2014-06-16.
John R Kelly's current location address is 1019 Ghaner Rd Ste A, Port Matilda, Pennsylvania. You can contact this provider via phone number 8142387120 and fax number 8142382981. The mailing address for John R Kelly is 1019 Ghaner Rd Ste A, Port Matilda, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John R Kelly |
|---|---|
| Address | 1019 Ghaner Rd Ste A, Port Matilda, Pennsylvania |
| Phone Number | 8142387120 |
| Fax Number | 8142382981 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1861615569 |
|---|---|
| Provider Enumeration Date | 2007-04-11 |
| Last Updated Date | 2014-06-16 |
Provider Mailing Address Detail
| Address | 1019 Ghaner Rd Ste A |
|---|---|
| City | Port Matilda |
| State | Pennsylvania (PA) |
| Post Code | 168707201 |
| Phone Number | 8142387120 |
| Fax Number | 8142382981 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | DS-019843-L |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5104610001 | PA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to John R Kelly?
The John R Kelly has been issued the NPI (National Provider Identifier) 1861615569 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where John R Kelly is geographically located?
The John R Kelly is physically situated at the following location: 1019 Ghaner Rd Ste A, Port Matilda, PA, 168707201.
What is the area of specialization for John R Kelly, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for John R Kelly is Pediatric Dentistry, and the corresponding taxonomy code that categorizes this area of expertise is 1223P0221X.
On what date was the 1861615569 assigned to John R Kelly?
The John R Kelly was issued its 1861615569 on 2007-04-11, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to John R Kelly, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to John R Kelly, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2014-06-16.
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