Michael Thomas Kelly, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

D7706 Issued in AZ

Practice address

9377 E Bell Rd
Suite 301
Scottsdale, AZ 85260-1502

Phone

(480) 513-2620

NPI assigned

Sep 6, 2005

Last updated

Jul 24, 2015By the provider in NPPES

Sex

Male

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aesthetic Dentistry of Scottsdale, PLC

  dba Aesthetic Dentistry of Scottsdale

  • Dental Clinic/Center
  • Scottsdale, AZ
  • NPI 1285419259
  NPD Authorized official
• Aesthetic Dentistry of Scottsdale

  • General Practice Dentistry
  • Scottsdale, AZ
  • NPI 1346451341
  NPD (past)

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1407840580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9377 E BELL RD",
            "address_2": "SUITE 301",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601502",
            "telephone_number": "480-513-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9377 E BELL RD",
            "address_2": "SUITE 301",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601502",
            "telephone_number": "480-513-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0013369",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D7706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Alexander Kelly, M.D.
• Gemini Kelly
• Grace Catherine Kelly, MD
• Lauren Kelly, OTR/L
• Maureen A Kelly, M.D.
• Penny Louise Kelly, LPC
• Susan Elizabeth Kelly, OTR L
• Thomas Edgar Kelly, M.D.
• Ellen G Kelman, PHD
• Timothy A Kelsch, MD

• Dentist in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.