W DAVID KELLY


Address: 59 Quinsigamond Ave, Worcester, MA 01610-1867
Phone: 5087992550

W DAVID KELLY (NPI# 1326041385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326041385
Entity Type Individual
Full Name W DAVID KELLY
Credential DMD
Practice Address 59 Quinsigamond Ave
Worcester
MA 01610-1867
Practice Telephone 5087992550
Practice Fax Number 5087562923
Mailing Telephone 5087992550
Mailing Fax Number 5087562923
Enumeration Date 2005-05-24
Last Update Date 2012-02-17
NPI Deactivation Date 03/16/2006
NPI Reactivation Date 2006-03-20
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
12222 MA Dental Providers

Office Location

Street Address 59 QUINSIGAMOND AVE
City WORCESTER
State MA
Zip Code 01610-1867

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811313513 Seth A. Brawer Physician Assistant 59 Quinsigamond Ave, Worcester County Orthopedics, Worcester, MA 01610-1867 2014-03-05
1033434659 Crompton Park Oral Surgery and Implant Associates, LLC Dentist 59 Quinsigamond Ave, Worcester, MA 01610-1867 2010-04-07
1093998387 Crompton Park Oral Surgery and Implant Associates, LLP Dentist 59 Quinsigamond Ave, Worcester, MA 01610-1806 2007-12-10
1841313921 Philip J Lahey Orthopaedic Surgery 59 Quinsigamond Ave, Ste 200, Worcester, MA 01610-1867 2007-04-06
1104850528 Christopher Jay Vinton Orthopaedic Surgery 59 Quinsigamond Ave, Worcester County Orthopedics, Worcester, MA 01610-1806 2006-07-10
1376528323 Philip J. Lahey Jr. Specialist 59 Quinsigamond Ave, Worcester, MA 01610-1806 2005-12-13
1396720348 Worcester County Orthopedics Specialist 59 Quinsigamond Ave, Worcester, MA 01610-1806 2005-12-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1881189355 Amber Hall Counselor 26 Queen St, 6th Floor, Worcester, MA 01610 2018-06-27
1417401951 Kelsey Moran Counselor 1 College Street, Box D, Worcester, MA 01610 2016-08-13
1245685809 Walter Trisdale Specialist/Technologist One College St., College of The Holy Cross, Worcester, MA 01610 2016-05-02
1669866430 Shannon Smith Student in an Organized Health Care Education/Training Program 26 Queen St, Ground Floor, Ambulatory Psychiatry Service, Ummmc, Worcester, MA 01610 2015-03-19
1063815348 Terri Boettcher Social Worker 72 Jacques Street, Worcester, MA 01610 2014-10-01
1700222866 Kalynn Lucashensky Occupational Therapist 105 Woodland St. Apt. A, Worcester, MA 01610 2013-05-16
1093053993 Chrissy Marie Ryan Registered Nurse 26 Queen St 6th Floor, Flow Pact, Worcester, MA 01610 2013-01-28
1851681324 Renaissance Adult Day Care, LLC Clinic/Center 1040 Southbridge Street, Worcester, MA 01610 2011-04-18
1912203217 Goddard/homestead Custodial Care Facility 10 Homestead Avenue, Worcester, MA 01610 2011-02-03
1912173196 Rahman Ullah Dentist Park Ave Dental Center, 456 Park Avenue, Worchester, MA 01610 2008-05-07
Find all providers in zip 01610

Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245249820 Xue Yu Shen Dentist 9 Linden Street, Worcester, MA 01609 2006-08-05
1982149514 Oral Surgery Partners PC Dentist 388 Park Ave, Worcester, MA 01610-1025 2017-01-06
1033434659 Crompton Park Oral Surgery and Implant Associates, LLC Dentist 59 Quinsigamond Ave, Worcester, MA 01610-1867 2010-04-07
1679747398 Bay State Oral Surgery Associates, Inc. Dentist 9 Linden Street, Worcester, MA 01609 2008-04-14
1093998387 Crompton Park Oral Surgery and Implant Associates, LLP Dentist 59 Quinsigamond Ave, Worcester, MA 01610-1806 2007-12-10
1295941607 Laurie Manthos Dentist 200 Lincoln St, Suite 1, Worcester, MA 01605-2528 2007-05-15
1285750596 Laurie Manthos, D.m.d., P.C. Dentist 200 Lincoln St, Suite 1, Worcester, MA 01605-2528 2007-03-21
1053470740 Worcester Oral Surgery, P.C. Dentist 299 Lincoln Street, Suite 204, Worcester, MA 01605-3609 2006-12-08
1225109903 Jasjit Singh Gill Dentist 299 Lincoln St, Suite 204, Worcester, MA 01605-3609 2006-11-13
1659442325 Christopher Kevin Clancy Dentist 299 Lincoln St, Suite 204, Worcester, MA 01605-3609 2006-11-13
Find all providers in WORCESTER

Competitor

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City WORCESTER
Zip Code 01610

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Dataset Information

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.

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