Paul Kelly Maxillofacial PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D6913 Issued in AZ

Legal business name

PAUL KELLY MAXILLOFACIAL PC

Practice address

726 N Greenfield Rd
Suite #117
Gilbert, AZ 85234-5061

Phone

(480) 258-0879

NPI assigned

May 1, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Paul John Kelly, DMD MSNPI 1447202148

Title

Doctor and Owner

Phone

(480) 258-0879

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul John Kelly, DDS, MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Gilbert, AZ
  • NPI 1447202148
  NPD (past) Authorized official

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430438400000",
    "number": "1316324031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 N GREENFIELD RD",
            "address_2": "SUITE #117",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852345061",
            "telephone_number": "480-258-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 N GREENFIELD RD",
            "address_2": "SUITE #117",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852345061",
            "telephone_number": "480-258-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL KELLY MAXILLOFACIAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-05-01",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DOCTOR AND OWNER",
        "authorized_official_telephone_number": "480-258-0879",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD MS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D6913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Alan Patterson, M.D.
• John Rigby Patterson, M.D.
• Kiri Patterson, RBT
• Kathyrn Patti, RBT
• Paul a. Mikel MD PLC
• Anthony Pauls, PHARMD
• Brian T Pavlue, PAC
• Janessa Paxton
• Armand Payne, DPT
• Ashley Payne, P.T.

• Oral and Maxillofacial Surgery (Dentist) in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.