DR. KELLY ROSS CARLISLE (NPI# 1275097859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275097859 |
| Entity Type | Individual |
| Full Name | DR. KELLY ROSS CARLISLE |
| Credential | DMD, BS |
| Practice Address |
535 E 500 S Bountiful UT 84010-3873 |
| Mailing Address |
391 W 3200 S Bountiful UT 84010 |
| Practice Telephone | 8012927807 |
| Mailing Telephone | 4086217744 |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2020-04-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 11287528-9922 | UT | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2453 S Wildcat Way Ste A, Woods Cross, UT 840108292 | 4086217744 | |
| 4802 S Holladay Blvd, Holladay, UT 841175407 | 8017337035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760461875 | Kelly Morgan Carlisle | Internal Medicine | One Saint Mary Place, Shreveport, LA 71101-0000 | 2006-01-17 |
| Street Address |
535 E 500 S |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-3873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578618856 | Nancy Narrod Pantziris | Psychiatry & Neurology | 535 E 500 S, Suite 6, Bountiful, UT 84010-3873 | 2007-01-24 |
| 1437487360 | Hand & Orthopedic Rehabilitation Specialists PC | Physical Therapist | 535 E 500 S, No. 8, Bountiful, UT 84010-3873 | 2009-12-04 |
| 1184830705 | Kenneth Pugmire Schwab | Marriage & Family Therapist | 535 E 500 S, Suite 5, Bountiful, UT 84010-3873 | 2007-05-14 |
| 1720290802 | Chris Reed Simonsen | Dentist | 535 E 500 S, Bountiful, UT 84010-3873 | 2007-05-03 |
| 1740405620 | David M Chamberlain | Dentist | 535 E 500 S, Suite #2, Bountiful, UT 84010-3873 | 2007-04-16 |
| 1497893473 | Thomas Francis Page | Dentist | 535 E 500 S, Suite C, Bountiful, UT 84010-3873 | 2007-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689282089 | Nathan Elmer Kobold | Dentist | 188 E 2050 S Apt B4, Bountiful, UT 84010-5456 | 2020-07-21 |
| 1609240027 | Dental Designs of Bountiful | Dentist | 1480 Orchard Dr Ste 109, Bountiful, UT 84010-5177 | 2015-11-23 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| 1598162141 | Modern Dental Professionals - Utah, PC | Dentist | 24 South 500 West, #d, Bountiful, UT 84010 | 2014-11-25 |
| 1346681483 | Devin Jay Orvin | Dentist | 24 S 500 W, Bountiful, UT 84010-1916 | 2013-07-16 |
| 1831325695 | Trever E Keele | Dentist | 81 W 500 S, Bountiful, UT 84010-6229 | 2009-06-08 |
| 1992969380 | Jennifer W Wyson | Dentist | 1512 Renaissance Towne Drive, Suite 200, Bountiful, UT 84010 | 2008-07-15 |
| 1649467184 | Robert H. Johnson | Dentist | 692 W 3300 S, Bountiful, UT 84010-8346 | 2007-09-28 |
| 1902099088 | Roger K Jones | Dentist | 625 East 500 South #202, Bountiful, UT 84010 | 2007-08-22 |
| 1902004450 | Jay Glen Shields | Dentist | 1037 East Claremont Dr, Bountiful, UT 84010 | 2007-07-06 |
| Find all providers in BOUNTIFUL | ||||
Please comment or provide details below to improve the information on DR. KELLY ROSS CARLISLE.
| 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.