Kelly P Couch DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29029 Issued in CA

Legal business name

KELLY P COUCH DDS INC

Practice address

7915 Laguna Blvd
Suite #110
Elk Grove, CA 95758-7945

Phone

(916) 683-2300

Fax

(916) 683-2352

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Kelly P Couch, DDSNPI 1629192380

Title

Owner

Phone

(916) 683-2300

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.

• Kelly P Couch, DDS

  • General Practice Dentistry
  • Elk Grove, CA
  • NPI 1629192380
  NPD (past) Authorized official

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326261694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7915 LAGUNA BLVD",
            "address_2": "SUITE #110",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587945",
            "telephone_number": "916-683-2300",
            "fax_number": "916-683-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7915 LAGUNA BLVD",
            "address_2": "SUITE #110",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587945",
            "telephone_number": "916-683-2300",
            "fax_number": "916-683-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY P COUCH DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COUCH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-683-2300",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abegail Keh
• Andrew Keh
• Patrick Alan Keleher, MT-BC
• Timothy A Keller, LMFT
• Tatiana Simone Kelley, MD
• Michael F. Kelly, MD
• Durrell Kendrick
• Nonyelum Nneka Kendricks
• Stephen William Kennedy, MD
• Jessica Deann Kenny, ASW

• General Practice Dentistry in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.