Kelly Koli Sawyer, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

20387 Issued in TX

Practice address

3013 Green Meadow
San Angelo, TX 76904-6435

Phone

(325) 947-7777

Fax

(325) 947-7771

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

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 TX

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

State licenses

Practice roles

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.

• Kelly K. Sawyer, D.D.S., P.a.

  • Pediatric Dentistry
  • San Angelo, TX
  • NPI 1548443203
  NPD (past) Authorized official
• The University of Texas Health Science Center at San Antonio

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD (past)
• University of Texas Health Science Center at San Antonio

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1992736573
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1295750206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3013 GREEN MEADOW",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046435",
            "telephone_number": "325-947-7777",
            "fax_number": "325-947-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3013 GREEN MEADOW",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046435",
            "telephone_number": "325-947-7777",
            "fax_number": "325-947-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWYER",
        "first_name": "KELLY",
        "middle_name": "KOLI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "20387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rob Peter Sarbach, PT
• Betty Saucedo, EIS-FQP
• Kristine Louise Saucer-Decker, LPC-S
• Saveall Pharmacies, Inc
• Kevin Saverance, LAT, ATC
• Stephen P Sawyer, MD
• Stephanie I Sayers, RPH
• Scci Hospitals of America Inc
• Christopher Douglas Schmidt, PT, DPT
• Delilah Mae Schnitzer, ACNP-BC

• Pediatric Dentistry in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.