NPIMap

Individual provider Active NPI

James Aaron Kelly, DDS., MS

  • Prosthodontics
  • Los Angeles, CA
National Provider Identifier
1184879983
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
59461 Issued in CA
Practice address
10833 Le Conte Avenue Room A0-156B CHS
UC Regents Maxillofacial Prosthodontics
Los Angeles, CA 90095-1668
Phone
(310) 825-5889
Fax
(310) 825-6345
NPI assigned
Nov 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 6741 NE
Dentist 122300000X 59461 CA
Prosthodontics 1223P0700X 59461 CA Primary

Addresses

Primary practice location

10833 Le Conte Avenue Room A0-156B CHS
UC Regents Maxillofacial Prosthodontics
Los Angeles, CA 90095-1668

Mailing address

10833 Le Conte Avenue Room A0-156B CHS
UC Regents Maxillofacial Prosthodontics
Los Angeles, CA 90095-1668
Phone (310) 825-5889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
59461CAMDProsthodontist
6741NEMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
UCLA Hospital Dentistry Past Accepting new patients
UCLA Graduate Prosthodontics Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1184879983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVENUE ROOM A0-156B CHS",
            "address_2": "UC REGENTS MAXILLOFACIAL PROSTHODONTICS",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951668",
            "telephone_number": "310-825-5889",
            "fax_number": "310-825-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVENUE ROOM A0-156B CHS",
            "address_2": "UC REGENTS MAXILLOFACIAL PROSTHODONTICS",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951668",
            "telephone_number": "310-825-5889",
            "fax_number": "310-825-6345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JAMES",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DDS., MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-20",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NE",
            "license": "6741",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59461",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "59461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.