Eileen Ann Kelley, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

20539DL Issued in OH

Practice address

349 Niles Cortland Rd NE
Warren, OH 44484-1976

Phone

(330) 856-5520

Fax

(330) 856-6481

NPI assigned

Feb 13, 2008

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)

Enrolled

State licenses

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1184892085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841976",
            "telephone_number": "330-856-5520",
            "fax_number": "330-856-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841976",
            "telephone_number": "330-856-5520",
            "fax_number": "330-856-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "EILEEN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "20539DL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Christen Keenan
• Kayla Keener, MSW, LISW-S
• Kacee Kehoe-Amsler, RN
• Amanda Kehres, LPN
• Kristie Kellar
• Kevin Daniel Kelley, M.D., PHD
• Patricia Kelley, COTA/L
• Donita H Kelly, LPTA
• Kellys Elite Boutique, LLC
• Mary E Kelty, LPN

• Periodontics in Warren, OH
• Providers in Warren, OH by specialty
• Periodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.