Diane C Kelly Dmd, Pc, NPI 1740452465
Pediatric Dentist in Gainesville, GA, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1740452465 |
| NPI Entity Type | Organization |
| Provider Name |
Diane C Kelly Dmd, Pc
Doing Business As |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 655 Jesse Jewell Pkwy Se, Gainesville, GA, US |
| Provider Mailing Address | 655 Jesse Jewell Pkwy Se, Gainesville, GA, US, 30501 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | DMD Diane C Kelly |
| Official Position | OWNER - AND PROVIDER |
| Phone | 678-714-7011 |
Group Taxonomy
| Taxonomy Code | 193400000X |
| Taxonomy Name | 193400000X MULTIPLE SINGLE SPECIALTY GROUP |
| Definition | A business group of one or more individual practitioners, all of who practice with the same area of specialization. |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Pediatric Dentist |
| Classification | |
| Group | |
| License No. | DNO12082 |
| License State | GA |
| Description | 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. |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 186794814A | GA | MEDICAID | 05 |
| 191450941A | GA | MEDICAID | 05 |
| 390489607J | GA | MEDICAID | 05 |
| 000046582Y | GA | MEDICAID | 05 |
| 919057925B | GA | MEDICAID | 05 |
| 514725717B | GA | MEDICAID | 05 |
| 000851727B | GA | MEDICAID | 05 |
| 609963109E | GA | MEDICAID | 05 |
| 218323780A | GA | MEDICAID | 05 |
| 609963109L | GA | MEDICAID | 05 |
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