Kelli Rose Ehemann, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30.026558 Issued in OH

Practice address

1330 Clark St
Cambridge, OH 43725-9614

Phone

(740) 421-9530

Fax

(740) 421-9531

NPI assigned

Jun 15, 2021

Last updated

Jun 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1376111427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 ADAIR AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012836",
            "telephone_number": "740-891-9000",
            "fax_number": "740-891-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 CLARK ST",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437259614",
            "telephone_number": "740-421-9530",
            "fax_number": "740-421-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHEMANN",
        "first_name": "KELLI",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026558",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Cambridge, OH
• Providers in Cambridge, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.