DR. KENNETH RAYMOND KELLY (NPI# 1396914990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396914990 |
| Entity Type | Individual |
| Full Name | DR. KENNETH RAYMOND KELLY |
| Credential | DDS |
| Practice Address |
402 Princeton Rd Suite A Johnson City TN 37601-2057 |
| Practice Telephone | 4232834175 |
| Mailing Telephone | 4232834175 |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DS2230 | TN | Dental Providers |
| 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 |
| 1730224908 | Kenneth J Kelly | Emergency Medicine | 2000 Trident Way, San Diego, CA 92155-5599 | 2007-02-21 |
| 1003883083 | Kenneth J. Kelly | Dentist | 111 Grossman Dr, Braintree, MA 02184-4997 | 2006-03-08 |
| 1740255942 | Kenneth Farrel Kelly | Emergency Medicine | 2669 Scenic Dr, Alamogordo, NM 88310-8700 | 2006-02-21 |
| Street Address |
402 PRINCETON RD SUITE A |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37601-2057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922086123 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 402 Princeton Rd, Johnson City, TN 37601-2057 | 2006-01-06 |
| 1194734335 | Kenneth R. Kelly, D.d.s, P.C. | Dentist | 402 Princeton Rd, Suite A, Johnson City, TN 37601-2057 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396381992 | Juan Carlos Simon Villegas Gomez | Specialist/Technologist | 1081 John Robert Bell Dr, Johnson City, TN 37601 | 2019-11-19 |
| 1629537279 | Jaima Suzanne Price | Hearing Instrument Specialist | 106 E Watauga Avenue, Johnson City, TN 37601 | 2019-03-13 |
| 1275004467 | Brittany Howell | Speech-Language Pathologist | 2114 E. Fairview Ave, Johnson City, TN 37601 | 2018-12-16 |
| 1194229948 | Heather Chantel Lester | Physical Therapist | 2114 E. Fairview Avenue, Johnson City, TN 37601 | 2018-03-19 |
| 1477061869 | Patrick Conway Reynolds | Specialist/Technologist | 1081 John Robert Bell Drive, Johnson City, TN 37601 | 2018-01-19 |
| 1790201135 | Surgical Services of East Tennessee PC | Surgery | 300 East Main St., Suite 301, Johnson City, TN 37601 | 2017-08-17 |
| 1073065694 | Davina Leah Reppond | Home Health | 1204 E Myrtle Ave, Johnsoncity, TN 37601 | 2016-10-31 |
| 1003365503 | Wendi Y Minutolo | Behavioral Analyst | 403 Princeton Rd Ste 3, Johnson City, TN 37601 | 2016-09-25 |
| 1306208798 | Rachel Anne Anderson | Nurse Practitioner | 1118 East Holston Avenue, Johnson City, TN 37601 | 2016-03-24 |
| 1932560976 | Kaydee Louise Davidson | Occupational Therapist | 3209 Bristol Highway, Johnson City, TN 37601 | 2016-03-18 |
| Find all providers in zip 37601 | ||||
| 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 |
|---|---|---|---|---|
| 1154980217 | Michael Ryan Fuchs | Dentist | 508 Princeton Rd Ste 101, Johnson City, TN 37601-2060 | 2019-06-11 |
| 1437658507 | Advanced Dental and Anesthesia Solutions LLC | Dentist | 135 Marketplace Dr Ste 101, Johnson City, TN 37604-8933 | 2018-02-05 |
| 1366996084 | Amy Herron Moody | Dentist | 108 W 10th Ave, Johnson City, TN 37604-3800 | 2016-08-10 |
| 1205063203 | Phung Pham Johnson | Dentist | 520 W Oakland Ave, Suite 6, Johnson City, TN 37604-1654 | 2009-06-17 |
| 1053552307 | Allcare Dental & Dentures | Dentist | 2301 N Roan St, Johnson City, TN 37601-1701 | 2009-03-17 |
| 1679767669 | Thomas Russell Seaver | Dentist | 401 W Walnut St, Johnson City, TN 37604-6713 | 2007-09-01 |
| 1578761953 | William Thomas Baker Jr. | Dentist | 300 West Watauga Avenue, Johnson City, TN 37604 | 2007-07-06 |
| 1912115866 | Hugh Charles Mohler | Dentist | 513 E Unaka Ave, Johnson City, TN 37601-4032 | 2007-05-21 |
| 1891816534 | Walter Jeff Banyas | Dentist | 216 W Watauga Ave, Johnson City, TN 37604-5624 | 2007-04-02 |
| 1306981915 | Lester G Koe Jr. | Dentist | 106 East Unaka Ave, Johnson City, TN 37601-4624 | 2007-02-21 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37601 |
Please comment or provide details below to improve the information on DR. KENNETH RAYMOND KELLY.
| 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.