Kelly Fitzgerald Burns, DMD
Individual provider Active NPI Dentist · Montpelier, VT
NPI 1124408182 · NPPES record last updated Nov 15, 2016
Key facts
- NPI
- 1124408182
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 0160112318 (VT)
- Practice address
- 152 Main St
Montpelier, VT 05602-2913 - Phone
- (802) 229-0690
- NPI assigned
- Jun 4, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0160112318 | VT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Main Street Family Dentistry, PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0160112318 | VT | Yes |
Addresses
Primary practice location
152 Main St
Montpelier, VT 05602-2913
Mailing address
152 Main St
Montpelier, VT 05602-2913
Phone (802) 229-0690
Other names
- Dr. Kelly Fitzgerald
Other providers in Montpelier, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.