Kelly Elizabeth Ellen Yeung, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901019319 Issued in MI

Practice address

1617 E Milham Ave
Portage, MI 49002-3049

Phone

(269) 381-7250

Fax

(268) 381-7790

NPI assigned

Oct 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kelly Elizabeth Ellen Rowe Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1255528311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 E MILHAM AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490023049",
            "telephone_number": "269-381-7250",
            "fax_number": "268-381-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 E MILHAM AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490023049",
            "telephone_number": "269-381-7250",
            "fax_number": "268-381-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEUNG",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH ELLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "ROWE",
            "middle_name": "ELIZABETH ELLEN",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janice Lee Wyn
• Robert James Yarbrough Jr., PT, DPT
• Jennifer Yarger
• Mary Ellen Yealin
• Beverly Yee, MTOM, LAC
• Robert S Yeung, DDS, MS
• Young Men'S Christian Association of Kalamazoo
• Alison Bailey Young
• Delarren Young
• Laythen Young, PT

• Dentist in Portage, MI
• Providers in Portage, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.