Kelly Hartnett McDermott, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22144 Issued in TX

Practice address

111 Gaslight Blvd
Suite a
Lufkin, TX 75904-3188

Phone

(936) 634-8201

Fax

(936) 639-2187

NPI assigned

Dec 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Kelly Hartnett McDermott Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1124183330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GASLIGHT BLVD",
            "address_2": "SUITE A",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043188",
            "telephone_number": "936-634-8201",
            "fax_number": "936-639-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GASLIGHT BLVD",
            "address_2": "SUITE A",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043188",
            "telephone_number": "936-634-8201",
            "fax_number": "936-639-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "KELLY",
        "middle_name": "HARTNETT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175004401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MCDERMOTT",
            "middle_name": "HARTNETT",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dixie Ann McClendon-Coker, M.D.
• Haley Bennett McClendon, DDS
• Levi McClendon, PHD, LPC-S, RPT
• Sharon S McClure, LPC
• Brittany McCreary, PHD, LP
• Tanya K McDonald, CRNA
• Eva Faye McDuffie
• Ashley Nicole McElroy, M.D.
• Hillary McElroy, NP
• Patricia Ann McGaughey, RN

• General Practice Dentistry in Lufkin, TX
• Providers in Lufkin, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.