Chad H. Kelly, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

11493 Issued in MN

Practice address

14605 Glazier Ave
Apple Valley, MN 55124-7545

Phone

(952) 432-1103

NPI assigned

Jan 22, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316091010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14605 GLAZIER AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247545",
            "telephone_number": "952-432-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14605 GLAZIER AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247545",
            "telephone_number": "952-432-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CHAD",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "11493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Joseph Karan, LPCC
• Jeremy Kauppi, PT
• Jacqueline Marie Kay, PT, DPT
• Nicolette Renee Keehr, DNP, AGNP-C
• Jane Witon Keith, PHARM.D.
• Ronald Joseph Kent, DDS
• Brooke Elizabeth Kern, MSN, PMHNP-BC,AGNP-C
• Angela Keys, MA, LPC
• Nakisa Ashley Khoshnevis, PSY.D, LP
• Myrna Ann Kiel, LICSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.