Robert Kelleher, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

J 28736 Issued in CA

Practice address

13385 Folsom Blvd
Folsom, CA 95630-8004

Phone

(916) 985-8420

Fax

(916) 985-6109

NPI assigned

Jun 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Regents of the Univ of Ca

  • Maternal & Fetal Medicine Physician
  • Sacramento, CA
  • NPI 1013906973
  Medicare reassignment NPD
• Regents of the Univ of Ca

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1477546406
  NPD
• Regents of the Univ of Ca

  • Otolaryngology Physician
  • Sacramento, CA
  • NPI 1750374872
  NPD
• Regents of the Univ of Ca

  • Pulmonary Disease Physician
  • Sacramento, CA
  • NPI 1437142692
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053513531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13385 FOLSOM BLVD",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308004",
            "telephone_number": "916-985-8420",
            "fax_number": "916-985-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13385 FOLSOM BLVD",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308004",
            "telephone_number": "916-985-8420",
            "fax_number": "916-985-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "J 28736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle James Kearney, LPCC
• Tess Keehn, L.M.F.T.
• Hailee Madison Keeler
• Keikhan and Ebrahimi Adc
• Kathy Keikhan Ebrahimi, DDS
• Tori Kelley
• Bernadette Ann Kelly, MD
• Catherine Jameson Lee Kelly
• Li Kelly
• Kenneth T Sumida MD Inc

• Orthodontics and Dentofacial Orthopedics Dentistry in Folsom, CA
• Providers in Folsom, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.