DR. DIANE COLLETTE KELLY (NPI# 1851431522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851431522 |
| Entity Type | Individual |
| Full Name | DR. DIANE COLLETTE KELLY |
| Credential | DMD |
| Practice Address |
2119 Hamilton Creek Pkwy Suite 200 Dacula GA 30019-3293 |
| Practice Telephone | 6787147011 |
| Practice Fax Number | 6787148388 |
| Mailing Telephone | 6787147011 |
| Mailing Fax Number | 6787148388 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2013-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN012082 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | DENTAL LICENSE NUMBER | DN012082 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134789100 | Diane Kelly | Student in an Organized Health Care Education/Training Program | Loma Linda University Health- Pediatrics, 11234 Anderson Street, Loma Linda, CA 92354-2804 | 2019-06-20 |
| 1083672406 | Diane M Kelly | Specialist | 7902 Ne St Johns Rd, Vancouver, WA 98665-1094 | 2006-05-03 |
| 1932767928 | Diane Kelly | Occupational Therapist | 5372b Old Virginia St, Urbanna, VA 23175-2179 | 2019-06-04 |
| 1932410933 | Diane Kelly | Registered Nurse | 940 Central Park Dr Ste 101, Steamboat Springs, CO 80487-8816 | 2010-06-24 |
| 1871720177 | Diane Claire Kelly | Counselor | 225 Nw Lindvig Way, Suite 10, Poulsbo, WA 98370-6520 | 2009-06-15 |
| 1659537462 | Diane Kelly | Occupational Therapist | 149 N Main St, Fairport, NY 14450-1434 | 2008-07-31 |
| 1942417035 | Diane G Kelly | Social Worker | 260 Newport Center Dr, Ste 203, Newport Beach, CA 92660-7520 | 2007-05-17 |
| 1083783278 | Diane M Kelly | Nurse Practitioner | 8 Denison Pkwy E, Suite 201, Corning, NY 14830-2638 | 2006-11-06 |
| 1578582375 | Diane Salmon Kelly | Chiropractor | 1460 Ritchie Hwy, Suite 206, Arnold, MD 21012-2730 | 2006-07-19 |
| 1932190600 | Diane J Kelly | Obstetrics & Gynecology | 1223 Gateway Dr, Melbourne, FL 32901-2607 | 2005-11-02 |
| Street Address |
2119 HAMILTON CREEK PKWY SUITE 200 |
| City | DACULA |
| State | GA |
| Zip Code | 30019-3293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487102257 | Chattahoochee Family Orthodontics | Dentist | 2119 Hamilton Creek Pkwy, Ste 201, Dacula, GA 30019-3293 | 2016-09-21 |
| 1952764797 | Children and Teen Dental Group | Dentist | 2119 Hamilton Creek Pkwy, Suite 200, Dacula, GA 30019-3293 | 2016-03-30 |
| 1538379441 | Brian Thomas Kinsey | Dentist | 2119 Hamilton Creek Pkwy, Suite 204, Dacula, GA 30019-3293 | 2007-05-22 |
| 1336267905 | Nicola R. Thomas | Dentist | 2119 Hamilton Creek Pkwy, Suite 200, Dacula, GA 30019-3293 | 2007-03-26 |
| 1437283025 | Children's Dentistry At Hamilton Mill | Dentist | 2119 Hamilton Creek Pkwy, Suite 200, Dacula, GA 30019-3293 | 2007-03-15 |
| 1902933161 | David A. Skoglund | Dentist | 2119 Hamilton Creek Pkwy, Suite 200, Dacula, GA 30019-3293 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228171 | Mackenson Lafortune | Physical Therapy Assistant | 1424 Filigree Pl, Dacula, GA 30019 | 2019-10-29 |
| 1780167452 | Adenike Alaga | Registered Nurse | 3196 Dolostone Way, Dacula, GA 30019 | 2018-09-10 |
| 1780160580 | Cielitha Ruffin | Nurse Practitioner | 1223 Bentley Estates Dr., Dacula, GA 30019 | 2018-07-15 |
| 1386135663 | Anke Mbapeh | Nurse Practitioner | 2100 Browning Bend Ct, Dacula, GA 30019 | 2018-05-23 |
| 1053820282 | Ethan Zachariah Merrow | Student in an Organized Health Care Education/Training Program | 1701 Mulberry Lake Drive, Dacula, GA 30019 | 2017-09-20 |
| 1043737547 | Dawn Hedley | Dietitian, Registered | 3567 Vern Way, Dacula, GA 30019 | 2017-08-25 |
| 1831545367 | Angela Owusu-edusei | Nurse Practitioner | 3226 Dolostone Way, Dacula, GA 30019 | 2016-05-13 |
| 1528458718 | Philomena Gyamfi | Registered Nurse | 1088 Milford Ln, Dacula, GA 30019 | 2015-01-27 |
| 1417375247 | Casey Goldman Sommerfeld | Pediatrics | 2240 Hamilton Creek Pkwy Ste 600, Dacula, GA 30019 | 2014-03-29 |
| 1417398215 | Samia Tahil | Home Health | 2821 Spence Ct, Dacula, GA 30019 | 2013-07-10 |
| Find all providers in zip 30019 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538692314 | Samuel S. Kwon,dmd-iv Center PC | Dentist | 3590 Braselton Hwy Bldg B, Ste 100, Dacula, GA 30019-1117 | 2017-04-07 |
| 1306072533 | Shaki Chaudhary Jameson | Dentist | 3590 Braselton Hwy Ste 201, Dacula, GA 30019-1120 | 2009-06-02 |
| 1457476608 | Samuel S Kwon Dmd PC | Dentist | 3590 Braselton Hwy, Suite 201, Dacula, GA 30019-1117 | 2007-03-20 |
| 1952751695 | Tamerah Lorraine Marable | Dentist | 3590 Braselton Hwy Ste 201, Dacula, GA 30019 | 2016-06-14 |
| 1952764797 | Children and Teen Dental Group | Dentist | 2119 Hamilton Creek Pkwy, Suite 200, Dacula, GA 30019-3293 | 2016-03-30 |
| 1619203049 | Suhyun Rue | Dentist | 3590 Braselton Hwy Ste 201, Dacula, GA 30019 | 2009-10-20 |
| 1437283025 | Children's Dentistry At Hamilton Mill | Dentist | 2119 Hamilton Creek Pkwy, Suite 200, Dacula, GA 30019-3293 | 2007-03-15 |
| 1902933161 | David A. Skoglund | Dentist | 2119 Hamilton Creek Pkwy, Suite 200, Dacula, GA 30019-3293 | 2007-02-27 |
| 1013054402 | Sam S Kwon | Dentist | 3635 Braselton Hwy, Suite C, Dacula, GA 30019-1068 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895002 | Ashley Starnesdmd LLC | Dentist | 5482 Chamblee Dunwoody Rd Ste 9, Dunwoody, GA 30338-4142 | 2020-09-14 |
| 1912518531 | Samuel S Kwon - Athens Dmd PC | Dentist | 1795 Resurgence Drive, Suite 101, Watkinsville, GA 30677 | 2020-08-17 |
| 1366060618 | A Dental Home 4 Kidz | Dentist | 155 Carnegie Pl Ste 201, Fayetteville, GA 30214-3981 | 2020-07-13 |
| 1255973566 | Rehoboth Life Care Ministries, Inc | Dentist | 3208 Hwy 41, Byron, Byron, GA 31008 | 2019-10-09 |
| 1629619200 | Peachtree Hills Pediatric Dentistry | Dentist | 2385 Peachtree Rd Ne Ste A2ab, Atlanta, GA 30305-4139 | 2019-10-04 |
| 1871145557 | Dogwood Pediatric Dentistry of Statesboro, LLC | Dentist | 123 Hill Pond Ln, Statesboro, GA 30458-0872 | 2019-07-12 |
| 1952969396 | Ns3 Services, LLC | Dentist | 1039 Grant St Se Ste B11, Atlanta, GA 30315-2050 | 2019-05-31 |
| 1871050872 | Warner Robins Pediatric Dentistry LLC | Dentist | 102 S Houston Rd, Warner Robins, GA 31088-3904 | 2019-02-26 |
| 1730646886 | Smiles for Kids Norcross PC | Dentist | 3953 Holcomb Bridge Rd Ste 100, Peachtree Corners, GA 30092-5201 | 2019-02-25 |
| 1073083127 | Pediatric Dentistry of Central Georgia - Macon LLC | Dentist | 5437 Bowman Rd Ste 300, Macon, GA 31210-6575 | 2018-12-03 |
| Find all providers with the same taxonomy | ||||
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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.