Active NPI
Kelly Denise Berry, LDH
- Dental Hygienist
- Kokomo, IN
National Provider Identifier
1275426934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 13004674A
- Practice address
- 3118 S Lafountain St
Kokomo, IN 46902-3710 - Phone
- (765) 864-4160
- NPI assigned
- Jun 2, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 13004674A | IN | Primary |
Addresses
Primary practice location
3118 S Lafountain St
Kokomo, IN 46902-3710
Mailing address
3118 S Lafountain St
Kokomo, IN 46902-3710
Phone (765) 864-4160
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13004674A | IN | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748822400000",
"number": "1275426934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3118 S LAFOUNTAIN ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023710",
"telephone_number": "765-864-4160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3118 S LAFOUNTAIN ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023710",
"telephone_number": "765-864-4160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "KELLY",
"middle_name": "DENISE",
"credential": "LDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-02",
"last_updated": "2025-06-02",
"certification_date": "2025-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "IN",
"license": "13004674A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.