Steven William Kellett, D.D.S.
Individual provider Active NPI Dentist · Linton, IN
NPI 1104238526 · NPPES record last updated Dec 18, 2021
Key facts
- NPI
- 1104238526
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12012106A (IN)
- Practice address
- 190 C St NW
Linton, IN 47441-1328 - Phone
- (812) 847-8646
- NPI assigned
- May 21, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160202000252 | IN | Order and Referring Only - Dentist |
6103120787 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shakamak Family Dentistry, LLC | Current | Accepting new patients | |
| Steven W Kellett | Past |
Accepting new patients |
Locations
206 S Meridian St
Jasonville, IN 47438
Phone (812) 665-2275
190 C St NW
Linton, IN 47441
Phone (812) 847-8646
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12012106A | IN | Yes |
Addresses
Primary practice location
190 C St NW
Linton, IN 47441-1328
Mailing address
190 C St NW
Linton, IN 47441-1328
Other providers in Linton, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.