DR. NICHOLAS KELLEY (NPI# 1629431960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629431960 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS KELLEY |
| Credential | DMD, MSD |
| Practice Address |
201 Lyons Ave Newark NJ 07112-2027 |
| Mailing Address |
418 Birdwood Ave Haddonfield NJ 08033-1111 |
| Practice Telephone | 6093154324 |
| Mailing Telephone | 6093154324 |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2019-10-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
060827 | NY | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861729709 | Nicholas Owen Kelley | Pediatrics | 125 Clairemont Ave Ste 190, Decatur, GA 30030 | 2009-11-13 |
| 1962034801 | Nicholas Kelley | Counselor | 359 Fenn St, Pittsfield, MA 01201-5261 | 2020-02-09 |
| 1760830269 | Nicholas Kelley | Student in an Organized Health Care Education/Training Program | 10800 Knights Rd, Philadelphia, PA 19114-4200 | 2016-05-25 |
| Street Address |
201 LYONS AVE |
| City | NEWARK |
| State | NJ |
| Zip Code | 07112-2027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982607149 | Dong Chen | Anesthesiology | 201 Lyons Ave, Newark, NJ 07112-2027 | 2005-05-23 |
| 1558962100 | Chris Kemen | Student in an Organized Health Care Education/Training Program | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-11-02 |
| 1275132904 | Special LLC | Emergency Medicine | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-10-23 |
| 1326646019 | University Medical Associates (om) | Internal Medicine | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-10-14 |
| 1063010742 | University Pediatric Associates (om) | Pediatrics | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-10-14 |
| 1932716586 | University Physician Associates of New Jersey, Inc. | Pediatrics | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-09-28 |
| 1225642200 | Cresencia E Leopold | Nurse Practitioner | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-09-07 |
| 1538786546 | Uri Netanel Schneider | Student in an Organized Health Care Education/Training Program | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-06-25 |
| 1275158032 | Nneka E Emenaka | Nurse Practitioner | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-06-08 |
| 1447874151 | Sarah Karron | Student in an Organized Health Care Education/Training Program | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-05-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129680 | Kimberly Sjockeia Smith-jones | Massage Therapist | 590 Irvine Turner Blvd, Newark, NJ 07112 | 2020-09-18 |
| 1346880325 | Latifat Olabisi Bamgbose | Licensed Practical Nurse | 233 Lehigh Avenue, #3, Newark, NJ 07112 | 2020-01-08 |
| 1316588122 | Leila Renee Grubbs | Counselor | 140 Chancellor Avenue, 1b, Newark, NJ 07112 | 2019-10-02 |
| 1891347225 | Obeng Pharmacy LLC | Pharmacy | 431-433 Elizabeth Avenue, Newark, NJ 07112 | 2019-07-16 |
| 1124595723 | Patience Marks | Nurse Practitioner | 15 Shaw Avenue, Newark, NJ 07112 | 2018-11-01 |
| 1215425145 | Johnbosco Okpala | Student in an Organized Health Care Education/Training Program | Nbimc 201 Lyons Ave, Newark, NJ 07112 | 2018-04-26 |
| 1700383809 | Big Sam's Services LLC | Home Health | 349 Hawthorne Avenue, Newark, NJ 07112 | 2018-04-06 |
| 1780117325 | Vivien Wai Tung Ku | Student in an Organized Health Care Education/Training Program | 201 Lyons Ave, Newark Beth Israel Medical Center, Department of Dentistry, Newark, NJ 07112 | 2017-04-11 |
| 1265839922 | Bhavinkumar Shah | Pharmacist | 178-180 Lyons Ave, Newark, NJ 07112 | 2014-11-24 |
| 1629377445 | Isaac Abiola Popoola | Registered Nurse | 357 Schley Aptb4, Newark, NJ 07112 | 2011-03-18 |
| Find all providers in zip 07112 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679139448 | Delaware Braces, LLC | Dentist | 2444 Pulaski Hwy Ste 200, Newark, DE 19702-3906 | 2019-05-16 |
| 1568941375 | Orange Street Spec LLC | Dentist | 509a Orange Street Suite A, Newark, NJ 07107 | 2018-08-13 |
| 1144606310 | Rayanne Lee | Dentist | 110 Bergen Street, Rutgers School of Dental Medicine, Department of Orthodontics - Room C781, Newark, NJ 07103 | 2015-08-10 |
| 1508099938 | Andrew C Wong | Dentist | 3900 Newpark Mall Road, Suite 204, Newark, CA 94560-5241 | 2009-09-02 |
| 1366576373 | Thomas Wilson Beattie | Dentist | 589 Moull St, Newark, OH 43055-2909 | 2007-03-14 |
| 1932250735 | William D. Plikerd | Dentist | 974 N 21st St, Suite 1a, Newark, OH 43055-2990 | 2007-01-16 |
| 1205991668 | David S Briss | Dentist | 110 Bergen St Rm D884, Newark, NJ 07103-2495 | 2006-12-26 |
| 1366413528 | Brian E Crock | Dentist | 175 Mcmillen Dr, Newark, OH 43055-1810 | 2006-01-27 |
| 1841275609 | Robert E. Binder | Dentist | 110 Bergen Street, New Jersey Dental School, Department of Orthodontics, Newark, NJ 07101-1709 | 2005-12-14 |
| 1871064709 | Ezra Jared Brown | Dentist | 509 Orange St, Newark, NJ 07107-2128 | 2018-12-17 |
| Find all providers in NEWARK | ||||
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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.