Kelli Diane Creel

Primary specialty

DentistTaxonomy code 122300000X

License

37335 Issued in TX

Practice address

11831 Culebra Rd Ste 101
San Antonio, TX 78253-4578

Phone

(210) 625-5353

NPI assigned

Jun 28, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kcreel59844@direct.utmsa.com

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

• Purple Iris Dental Association

  • Pediatric Dentistry
  • San Antonio, TX
  • NPI 1558849893
  NPD (past)
• Restoration Dental PLLC

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1801253851
  NPD (past)
• Timberwood Childrens Dental Association PLLC

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1750983896
  NPD (past)

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1164092680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11138 HUEBNER OAKS APT 403",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301279",
            "telephone_number": "409-673-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11831 CULEBRA RD STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782534578",
            "telephone_number": "210-625-5353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18010 Bulverde Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782593346",
            "country_code": "US",
            "telephone_number": "210-729-0900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24815 US Highway 281 N Ste 111",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782582601",
            "country_code": "US",
            "telephone_number": "210-948-0642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8142 Tezel Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782503032",
            "country_code": "US",
            "telephone_number": "210-852-2003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREEL",
        "first_name": "KELLI",
        "middle_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "37335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sasha Julia Creedon, FNP
• Creekside Counseling of Westover Hills PLLC
• Creekside Open MRI Center LLC
• Creekview Counseling PLLC
• Cynthia Lynn Creel
• David Robert Cregg, PH.D.
• Amber Crenshaw, DNP, APRN, FNP-C
• Jeanette Crenshaw, MSN, APRN, FNP-BC
• Shannon Crenshaw, ACNP
• Veronica Jolene Crenwelge

• Dentist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.