MR. PATRICK JAMES KELLY (NPI# 1629149372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629149372 |
| Entity Type | Individual |
| Full Name | MR. PATRICK JAMES KELLY |
| Credential | DDS |
| Practice Address |
4009 Fort St Lincoln Park MI 48146-4110 |
| Practice Telephone | 3139288555 |
| Practice Fax Number | 3139281399 |
| Mailing Telephone | 3139288555 |
| Mailing Fax Number | 3139281399 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2017-03-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 2901016290 | MI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3334958 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730672833 | Patrick John Kelly | Dentist | 244 Fm 306 Ste 118, New Braunfels, TX 78130-5487 | 2018-06-13 |
| 1851895031 | Patrick Harry Kelly | Counselor | 5435 Bull Valley Rd Ste 230, Mchenry, IL 60050-7435 | 2018-03-21 |
| 1508391665 | Patrick Joel Kelly | Behavior Technician | 814 D St Apt 3, Sacramento, CA 95814-0722 | 2017-04-26 |
| 1720409824 | Patrick John Kelly | Physician Assistant | 3318 Broadway, Astoria, NY 11106-1806 | 2013-12-17 |
| 1881951622 | Patrick S Kelly | Dentist | 9860 Westpoint Dr Ste 100, Indianapolis, IN 46256-3398 | 2012-04-18 |
| 1821365198 | Patrick John Kelly | Physical Therapist | 1841 Broadway Rm 507, Suite 507, New York, NY 10023-7685 | 2011-11-30 |
| 1881971919 | Patrick Ryan Kelly | Registered Nurse | 1600 North Drive, Sioux Falls, SD 57117 | 2011-11-03 |
| 1821322710 | Patrick Kelly | Technician/Technologist | 1490 W Patapsco Ave, Baltimore, MD 21230-3400 | 2009-09-24 |
| 1457518003 | Patrick Britton Kelly | Dentist | 5352b Highway 90 W, Mobile, AL 36619-4202 | 2008-05-21 |
| 1306026919 | Patrick Francis Kelly | Pediatrics | 87 Cambridgepark Dr, Y2010, Cambridge, MA 02140-2311 | 2007-11-12 |
| Street Address |
4009 FORT ST |
| City | LINCOLN PARK |
| State | MI |
| Zip Code | 48146-4110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194081273 | Patrick J Kelly Dds, P.c | Dentist | 4009 Fort St, Lincoln Park, MI 48146-4110 | 2012-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356967251 | Luisa Sofia Amaya | Behavior Technician | 1360 Porter Ave, Lincoln Park, MI 48146 | 2020-06-17 |
| 1851854129 | Abhi Patel | Physical Therapist | 25050 W. Outer Dr, Ste: 204, Lincoln Park, MI 48146 | 2019-04-12 |
| 1831608827 | Back On Track Physical Therapy LLC | Clinic/Center | 1132 Southfield Road, Lincoln Park, MI 48146 | 2017-09-22 |
| 1326568221 | Priscilla Cano | Social Worker | 1600 Porter, Detroit, MI 48146 | 2017-06-21 |
| 1952650194 | Melissa Margaret Belinc | Psychologist | 26300 Outer Drive, Lincoln Park, MI 48146 | 2012-09-04 |
| 1497011746 | Richard John Daniels | Physical Therapy Assistant | 1538 Morris, Lincoln Park, MI 48146 | 2012-04-11 |
| 1740563261 | Myesha Renee Thurman | Social Worker | 26180 W. Outer Drive, Lincoln Park, MI 48146 | 2011-09-21 |
| 1033491162 | Heidi Bremer | Social Worker | 26180 West Outer Drive, Lincoln Park, MI 48146 | 2011-09-14 |
| 1871823526 | Richard Dale Mott | Counselor | 1564 Arlington, Lincoln Park, LA 48146 | 2009-12-31 |
| 1386801777 | Laura Ann Kaakati-weber | Psychologist | 26184 West Outer Drive, Lincoln Park, MI 48146 | 2008-05-22 |
| Find all providers in zip 48146 | ||||
| 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 |
|---|---|---|---|---|
| 1164037362 | David Posada | Dentist | 1326 Marion Ave, Lincoln Park, MI 48146-2090 | 2020-09-14 |
| 1336481431 | Katherine Shackleford | Dentist | 1359 Champaign Rd, Lincoln Park, MI 48146-3303 | 2013-03-27 |
| 1144435603 | Dental Health Group of Michgian | Dentist | 3257 Fort Road, Lincoln Park, MI 48146 | 2007-05-10 |
| 1871685933 | Ronald Mark Grumet | Dentist | 3830 Fort Street, Lincoln Park, MI 48146 | 2006-09-28 |
| 1649371121 | Lincoln Park Family Dentistry Dds PC | Dentist | 3326 Fort St, Lincoln Park, MI 48146 | 2006-09-26 |
| 1891708640 | Steven Craig Legel | Dentist | 3309 Dix Hwy, Lincoln Park, MI 48146-3415 | 2006-08-14 |
| 1700894599 | Thomas S Iulo | Dentist | 29 Station Rd, Lincoln Park, NJ 07035-1770 | 2006-08-04 |
| 1639544265 | Aziz Moukled | Dentist | 1193 Southfield Rd, Lincoln Park, MI 48146-2450 | 2015-12-08 |
| 1043623242 | Assia Mouabbi | Dentist | 1193 Southfield Rd, Lincoln Park, MI 48146-2450 | 2014-06-05 |
| 1801235270 | William Joseph Doherty | Dentist | 3784 Dix Hwy, Lincoln Park, MI 48146-3881 | 2013-06-19 |
| Find all providers in LINCOLN PARK | ||||
| City | LINCOLN PARK |
| Zip Code | 48146 |
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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.