KENNETH J. KELLY (NPI# 1003883083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003883083 |
| Entity Type | Individual |
| Full Name | KENNETH J. KELLY |
| Credential | DDS |
| Practice Address |
111 Grossman Dr Braintree MA 02184-4997 |
| Mailing Address |
147 Milk St Provider Enrollment 9th Floor Boston MA 02109-4806 |
| Practice Telephone | 7818492255 |
| Mailing Telephone | 6175598051 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2009-04-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
15939 | MA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BCBS - DENTAL | X05436 | 01 |
| MA | HARVARD PILGRIM | 40555 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548790454 | Kenneth Kelly | Hearing Instrument Specialist | 1754 Madison St Ste A, Clarksville, TN 37043-2923 | 2017-06-13 |
| 1205052487 | Kenneth Gregory Kelly | Psychologist | 2297 Knowles Flat Rd, Eden, VT 05652 | 2007-04-17 |
| 1336364660 | Kenneth Kelly | Psychologist | 1118 W Aztec Blvd, Aztec, NM 87410-1818 | 2007-04-13 |
| 1821301961 | Kenneth Jason Kelly | Physical Therapist | 300b Temple Lake Dr Ste 1, Colonial Heights, VA 23834-2973 | 2010-07-19 |
| 1598902512 | Kenneth Brian Kelly | Dentist | 201 Pleasant Valley Rd, Franklin, KY 42134-2722 | 2009-01-13 |
| 1396914990 | Kenneth Raymond Kelly | Dentist | 402 Princeton Rd, Suite A, Johnson City, TN 37601-2057 | 2008-02-27 |
| 1730224908 | Kenneth J Kelly | Emergency Medicine | 2000 Trident Way, San Diego, CA 92155-5599 | 2007-02-21 |
| 1740255942 | Kenneth Farrel Kelly | Emergency Medicine | 2669 Scenic Dr, Alamogordo, NM 88310-8700 | 2006-02-21 |
| Street Address |
111 GROSSMAN DR |
| City | BRAINTREE |
| State | MA |
| Zip Code | 02184-4997 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457352338 | Christopher Teitleman | Internal Medicine | 111 Grossman Dr, Braintree, MA 02184-4997 | 2005-08-02 |
| 1033550157 | Scott M Souther | Internal Medicine | 111 Grossman Dr, Braintree, MA 02184-4997 | 2013-07-17 |
| 1740575067 | Mehnaz Khan | Ophthalmology | 111 Grossman Dr, Braintree, MA 02184-4997 | 2011-06-15 |
| 1659670669 | Julie M Carragher | Nurse Practitioner | 111 Grossman Dr, Braintree, MA 02184-4997 | 2011-03-17 |
| 1508194622 | Veronica R Kane | Nurse Practitioner | 111 Grossman Dr, Pediatric Clinic, Braintree, MA 02184-4997 | 2009-12-01 |
| 1003044272 | Elise Rebecca Bender | Family Medicine | 111 Grossman Dr, Braintree, MA 02184-4997 | 2009-06-26 |
| 1508094772 | David Dildine | Family Medicine | 111 Grossman Dr, Family Medicine, Braintree, MA 02184-4997 | 2009-06-26 |
| 1457526006 | Tonya M Campbell | Nurse Practitioner | 111 Grossman Dr, Internal Medicine, Braintree, MA 02184-4997 | 2008-04-24 |
| 1427248558 | Lini S Bhatia | Internal Medicine | 111 Grossman Dr, Internal Medicine, Braintree, MA 02184-4997 | 2007-07-25 |
| 1902015266 | Hagen Yang | Psychiatry & Neurology | 111 Grossman Dr, Braintree, MA 02184-4997 | 2007-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342234 | Albert Jusu | Counselor | Arbour Counseling Services, 400 Washington Street, Braintree, MA 02184 | 2020-10-05 |
| 1356952378 | Samantha Taylor O'malley | Student in an Organized Health Care Education/Training Program | 639 Granite Street, N/a, Brainetree, MA 02184 | 2020-08-13 |
| 1184104499 | Andrea Boudreau | Social Worker | Coastal Dcf, 220 R Forbes Road, Braintree, MA 02184 | 2018-08-16 |
| 1144747221 | Mina Schafft Dmd Pllc | Dentist | 321 Washington Street, Unit 101, Westwood, MA 02184 | 2017-08-29 |
| 1922520592 | Samson Michel | Counselor | 400 Washington St. Suite 106, Braintree, MA 02184 | 2017-07-14 |
| 1760912653 | Shannon R Harvey | Behavioral Analyst | 501 Commerce Dr 4207, Braintree, MA 02184 | 2017-06-14 |
| 1275074429 | Colleen Dalton | Behavioral Analyst | 32 Powder Hill Dr, Braintree, MA 02184 | 2017-03-20 |
| 1295273266 | Jessica Morris | Occupational Therapist | 16 Kensington Street, Braintree, MA 02184 | 2017-02-09 |
| 1568834562 | Lisa Morrill | Counselor | 400 Washington St Ste 106, Braintree, MA 02184 | 2015-10-29 |
| 1831560382 | Dr Dental of Braintree PC | Dentist | 284 Grove St, Braintree, MA 02184 | 2015-10-09 |
| Find all providers in zip 02184 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205235900 | Andrew Joseph Baker | Dentist | 409 Pond St Ste 6, Braintree, MA 02184-6853 | 2014-08-19 |
| 1053441048 | Julius J Baronas | Dentist | 10 Cochato Rd, Braintree, MA 02184-4629 | 2007-03-07 |
| 1447385208 | Ronald Paul Hersey | Dentist | 1150 Washington St, Braintree, MA 02184-5440 | 2007-02-22 |
| 1538201025 | Martin E Geher Dmd | Dentist | 1703 Washington Street, Braintree, MA 02184-7934 | 2007-02-13 |
| 1851462923 | Venanzio Cardarelli | Dentist | 381 Washington St, Suite 5, Braintree, MA 02184-4741 | 2006-11-12 |
| 1902984420 | Dr George Salem and Associates PC | Dentist | 60 Adams Street, Braintree, MA 02184 | 2006-11-01 |
| 1275614752 | Rami Jradeh | Dentist | 103 Pearl St, Braintree, MA 02184-6525 | 2006-10-18 |
| 1780770339 | John C. Kimble | Dentist | 545 Washington Street, Braintree, MA 02184 | 2006-10-04 |
| 1073608303 | Sherine Rabbat | Dentist | 400 Washington St Ste 103, Braintree, MA 02184-4764 | 2006-10-03 |
| 1518974146 | Leonard G. Cuscianna | Dentist | 420 Washington St, 101, Braintree, MA 02184-4755 | 2006-08-03 |
| Find all providers in BRAINTREE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.