DR. SHAWN PATRICK KELLY (NPI# 1013082189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013082189 |
| Entity Type | Individual |
| Full Name | DR. SHAWN PATRICK KELLY |
| Credential | D.M.D. |
| Practice Address |
13 Somerdale Sq Somerdale NJ 08083-1345 |
| Mailing Address |
182 White Cedar Dr Sicklerville NJ 08081-3409 |
| Practice Telephone | 8565666969 |
| Practice Fax Number | 8565666012 |
| Mailing Telephone | 6097071032 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2013-05-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
22DI02260700 | NJ | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710385356 | Shawn Kelly | Physical Therapy Assistant | 1204 South Blvd, North Charleston, SC 29405-5228 | 2014-12-14 |
| 1225192131 | Shawn Connery Kelly | Counselor | 109 Petrolia Rd, Petrolia, PA 16050 | 2006-12-22 |
| 1427675107 | Shawn Kelly | Behavior Technician | 300 W Swanson Ave, Wasilla, AK 99654-6844 | 2020-06-29 |
| 1508393919 | Shawn Christine Kelly | Speech-Language Pathologist | 2820 Northup Way Ste 120, Bellevue, WA 98004-1419 | 2017-05-16 |
| 1336565712 | Shawn Kelly | Adult Companion | 945 Ne 165th Ave, Portland, OR 97230-6148 | 2014-03-10 |
| 1174831093 | Shawn Demian Kelly | Nurse Practitioner | 1061 Harmon Ave, Winn Ach, Fort Stewart, GA 31314-5641 | 2010-09-14 |
| 1932425329 | Shawn C. Kelly | Internal Medicine | 1101 26th St S, Great Falls, MT 59405-5161 | 2010-04-12 |
| 1003808395 | Shawn M Kelly | Optometrist | 2313 W Parker Rd, Plano, TX 75023-7839 | 2005-08-22 |
| Street Address |
13 SOMERDALE SQ |
| City | SOMERDALE |
| State | NJ |
| Zip Code | 08083-1345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851356000 | Kenson Emanuel Noel | Dentist | 13 Somerdale Sq, Umdnj-university Dental Center-somerdale, Somerdale, NJ 08083-1345 | 2006-04-19 |
| 1831452630 | Harris N Colton | Dentist | 13 Somerdale Sq, Somerdale, NJ 08083-1345 | 2012-06-18 |
| 1447430871 | Stanley T. Praiss | Dentist | 13 Somerdale Sq, Somerdale, NJ 08083-1345 | 2007-11-14 |
| 1467668533 | Richard William D'eustachio | Dentist | 13 Somerdale Sq, Somerdale, NJ 08083-1345 | 2007-05-15 |
| 1831302504 | Rutgers School of Dental Medicine | Clinic/Center | 13 Somerdale Sq, Somerdale, NJ 08083-1345 | 2007-05-08 |
| 1659337830 | George S. Mardirossian | Dentist | 13 Somerdale Sq, Somerdale, NJ 08083-1345 | 2006-04-25 |
| 1467418269 | Sunita Menon | Dentist | 13 Somerdale Sq, Somerdale, NJ 08083-1345 | 2006-04-21 |
| 1467417659 | Michael Steven Cappuccilli | Dentist | 13 Somerdale Sq, Somerdale, NJ 08083-1345 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053620351 | Wal-mart Stores East Lp | Technician/Technologist | 1 Coopertown Blvd, Somersdale, NJ 08083 | 2010-10-04 |
| 1336344548 | Diana Neal Juelg | Nurse Practitioner | 22 E. Evergreen Avenue, Somerdale, NJ 08083 | 2007-06-18 |
| 1598890295 | Shawn Thomas Klenk | Specialist/Technologist | 102 Rex Rd., Somerdale, NJ 08083 | 2007-02-22 |
| 1588741870 | John Raymond Tocco | Specialist | 701 W. Somerdale Road, Somerdale, NJ 08083 | 2006-11-01 |
| 1245218163 | Diana L Scott | Obstetrics & Gynecology | 1 Somerdale Sq, Somerdale, NJ 08083 | 2006-01-03 |
| 1013552702 | Integrity Family Solutions | Community/Behavioral Health | 104 Kennedy Blvd, Somerdale, NJ 08083-1019 | 2019-11-17 |
| 1649373978 | Vijay K Kalola | Internal Medicine | 227 E Somerdale Rd, Somerdale, NJ 08083-1105 | 2006-09-05 |
| 1639260896 | Primary Care Affiliates of Nj, Pa | Internal Medicine | 227 E Somerdale Rd, Somerdale, NJ 08083-1105 | 2006-09-27 |
| 1932203171 | Jayesh Patel | Internal Medicine | 227 E Somerdale Rd, Somerdale, NJ 08083-1105 | 2006-09-08 |
| 1295727642 | Alan D Budman | Podiatrist | 301 E Somerdale Rd, Somerdale, NJ 08083-1107 | 2005-08-19 |
| Find all providers in zip 08083 | ||||
| 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 |
|---|---|---|---|---|
| 1033329230 | Mitra Abdollahi | Dentist | 3 N White Horse Pike, Somerdale, NJ 08083-1740 | 2007-05-23 |
| 1942311295 | Jeffrey R Turner | Dentist | 736 W Somerdale Rd, Somerdale, NJ 08083-2443 | 2006-08-31 |
| 1851356000 | Kenson Emanuel Noel | Dentist | 13 Somerdale Sq, Umdnj-university Dental Center-somerdale, Somerdale, NJ 08083-1345 | 2006-04-19 |
| 1831452630 | Harris N Colton | Dentist | 13 Somerdale Sq, Somerdale, NJ 08083-1345 | 2012-06-18 |
| 1447430871 | Stanley T. Praiss | Dentist | 13 Somerdale Sq, Somerdale, NJ 08083-1345 | 2007-11-14 |
| 1467668533 | Richard William D'eustachio | Dentist | 13 Somerdale Sq, Somerdale, NJ 08083-1345 | 2007-05-15 |
| 1467418269 | Sunita Menon | Dentist | 13 Somerdale Sq, Somerdale, NJ 08083-1345 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861750 | Columbia Dental of Elizabeth Pa | Dentist | 151 Jefferson Avenue, Elizabeth, NJ 07201 | 2020-11-04 |
| 1790385490 | Progressive Dental Group | Dentist | 246 N Franklin Tpke Ste 4, Ramsey, NJ 07446-1635 | 2020-10-30 |
| 1205436029 | Nimitha Kumar | Dentist | 1216 John F Kennedy Blvd W, 2nd Floor, Bayonne, NJ 07002 | 2020-10-30 |
| 1811596307 | Kinjal J Mehta | Dentist | 151 Jefferson Ave, Elizabeth, NJ 07201-2490 | 2020-10-26 |
| 1093314668 | Chandan Venkatesh | Dentist | 193 Westgate Dr, Edison, NJ 08820-1164 | 2020-10-23 |
| 1326645664 | Amed Bientz Mendez | Dentist | 700 N Broad St Ste 101, Elizabeth, NJ 07208-2310 | 2020-10-08 |
| 1407463086 | Mina Youssef | Dentist | 821 Bergen Ave Apt B2, Jersey City, NJ 07306-4522 | 2020-09-28 |
| 1912518820 | Tyler Yim | Dentist | 44 Fairfield Dr, Short Hills, NJ 07078-1703 | 2020-08-13 |
| 1902416639 | Anna Lee | Dentist | 666 Plainsboro Rd Ste 408, Plainsboro, NJ 08536-3009 | 2020-08-06 |
| 1164032413 | Qurratulann Talat Khokhar | Dentist | 53 W 56th St, Bayonne, NJ 07002-4113 | 2020-08-02 |
| Find all providers with the same taxonomy | ||||
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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.