Joshua Chad Kelly, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN.00202592 Issued in CO

Practice address

375 W 4TH Ave
Severance, CO 80550

Phone

(970) 693-0080

Fax

(970) 693-0081

NPI assigned

Jul 29, 2015

Last updated

Jul 3, 2018By the provider in NPPES

Sex

Male

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

Enrolled in CO

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Severance Dental, PLLC

  • General Practice Dentistry
  • Severance, CO
  • NPI 1790288744
  NPD (past) Authorized official

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1225413461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 W 4TH AVE",
            "city": "SEVERANCE",
            "state": "CO",
            "postal_code": "805502949",
            "telephone_number": "970-693-0080",
            "fax_number": "970-693-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 W 4TH AVE",
            "city": "SEVERANCE",
            "state": "CO",
            "postal_code": "80550",
            "telephone_number": "970-693-0080",
            "fax_number": "970-693-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOSHUA",
        "middle_name": "CHAD",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00202592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrycia D Hatten, LPC.LAC
• Marina Hillyard
• Jessica Charlotte Huhn
• Jade Lotus Healing. LLC
• Jule Psychotherapy
• Krisanna Chadwick, Inc
• Elliott Anne Larson
• Brooke Denise Lee, LPC, CAC III, M.ED
• Bailey Lehman
• Marty Melland

• General Practice Dentistry in Severance, CO
• Providers in Severance, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.