DR. JESS ANDREW KELLY (NPI# 1063584563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063584563 |
| Entity Type | Individual |
| Full Name | DR. JESS ANDREW KELLY |
| Credential | D.D.S., M.S. |
| Practice Address |
1570 Adams St Mankato MN 56001-5192 |
| Mailing Address |
1759 Orchid Dr N North Mankato MN 56003-1431 |
| Practice Telephone | 5073860288 |
| Mailing Telephone | 5073440773 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
D11639 | MN | Dental Providers |
| Street Address |
1570 ADAMS ST |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-5192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851334775 | Scott B. Peters | Dentist | 1570 Adams St, Mankato, MN 56001-5192 | 2006-06-14 |
| 1891308979 | Southern Minnesota Endodontics LLC | Dentist | 1570 Adams St, Mankato, MN 56001-5192 | 2020-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891308979 | Southern Minnesota Endodontics LLC | Dentist | 1570 Adams St, Mankato, MN 56001-5192 | 2020-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568071199 | Dental Specialist of Minnesota, Pllc | Dentist | 18258 Minnetonka Blvd Ste 100, Wayzata, MN 55391-3324 | 2020-07-29 |
| 1215588660 | The Dental Specialist of Minnesota, Pllc | Dentist | 324 W Superior St Ste 824, Duluth, MN 55802-1718 | 2019-09-26 |
| 1780236539 | Modern Care Endodontics of Apple Valley | Dentist | 15160 Foliage Ave Ste 100, Apple Valley, MN 55124-5916 | 2019-07-11 |
| 1699268052 | Christopher Rex Lai | Dentist | 8-166 Moos Health Sciene Tower, 515 Delaware St. Se, Minneapolis, MN 55455 | 2018-06-11 |
| 1699272427 | Group Health Plan Inc | Dentist | 5500 Excelsior Blvd, St Louis Park, MN 55416-2935 | 2018-04-09 |
| 1225533037 | Younghyup Byun | Dentist | 1900 Kruchten Ct S Ste 100, Sartell, MN 56377-4731 | 2018-03-26 |
| 1275034886 | Great River Endodontics | Dentist | 9381 Cedar St., Monticello, MN 55362 | 2018-02-28 |
| 1417464157 | Deer River Dental Clinic | Dentist | 111 Main Street E, Deer River, MN 56636 | 2018-01-03 |
| 1174045975 | The Dental Specialists of Minnesota, Pllc | Dentist | 4640 Nicols Rd Ste 202, Eagan, MN 55122-7400 | 2017-07-13 |
| 1861914061 | The Dental Specialist of Minnesota, Pllc | Dentist | 2550 University Ave W Ste 155s, Saint Paul, MN 55114-1098 | 2017-07-10 |
| 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.