Gretchen Marie Kelley, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD3709 Issued in NM

Practice address

9501 Paseo del Norte NE Ste a
Albuquerque, NM 87122-2999

Phone

(505) 369-1881

Fax

(505) 369-1882

NPI assigned

Jul 10, 2012

Last updated

Jul 10, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Desert Ridge Dental

  • Dentist
  • Albuquerque, NM
  • NPI 1841664786
  NPD (past)

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1053676734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 PASEO DEL NORTE NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222999",
            "telephone_number": "505-369-1881",
            "fax_number": "505-369-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 PASEO DEL NORTE NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222999",
            "telephone_number": "505-369-1881",
            "fax_number": "505-369-1882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "GRETCHEN",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karolayn Keller
• Meredith Keller
• Rebecca Lynn Keller, NP
• Stephen C Keller, PA-C
• Evoanna Kileen Kelley Correa, LCSW
• Isabella Kelley
• Jonathan Harper Kelley, DDS
• Matthew Brian Kelley, M.A.
• Naomi Kelley, MD
• Ray Kelley, MD

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.