Rodney James Kellogg, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

42167 Issued in CA

Practice address

1879 E Fir Ave Ste 101
Fresno, CA 93720-3841

Phone

(559) 322-6060

Fax

(559) 322-7888

NPI assigned

May 7, 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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Kellogg and Grant Dental Corporation

  • General Practice Dentistry
  • Fresno, CA
  • NPI 1255885018
  NPD (past) Authorized official

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174736326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5381 E BEHYMER AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936199565",
            "telephone_number": "559-322-6060",
            "fax_number": "559-322-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1879 E FIR AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203841",
            "telephone_number": "559-322-6060",
            "fax_number": "559-322-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "RODNEY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "42167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Lynn Keller, CRNA
• Jerome David Kelley
• William Patrick Kelley Jr., D.O.
• Erica Kellison
• Kellogg and Grant Dental Corporation
• Brenna Jean Kelly
• Brian Edward Kelly
• Cassandra Kelly
• Catherine Cailing Kelly
• Christine Kelly, NP

• Dentist in Fresno, CA
• Providers in Fresno, CA by specialty
• Dentist in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.