Robert Thomas Kellogg, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS016898L Issued in PA

Practice address

1058 South Main Street
Meadville, PA 16335

Phone

(814) 724-4508

Fax

(814) 337-1405

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164560660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 SOUTH MAIN STREET",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "16335",
            "telephone_number": "814-724-4508",
            "fax_number": "814-337-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1058 SOUTH MAIN STREET",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "16335",
            "telephone_number": "814-724-4508",
            "fax_number": "814-337-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "ROBERT",
        "middle_name": "THOMAS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS016898L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008937830001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kellerman'S Counseling, LLC
• Rhiannon J Kenniston
• Beverly Lou Kerr, LPC
• Carrie Nicole Kerr, PHARMD
• Ketcham Chiropractic PLLC
• Jon Mark Ketcham, D.C.

• Dentist in Meadville, PA
• Providers in Meadville, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.