Patrick Anthony Kelly, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

11372 Issued in KY

Practice address

3801 S Hurstbourne Pkwy
Louisville, KY 40299-7319

Phone

(502) 709-9430

NPI assigned

Jun 9, 2025

Sex

Male

Sole proprietor

No

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

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

• Magnolia Dental

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1689183642
  NPD (past)

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1437043858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LOCKERBIE GRN",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463859276",
            "telephone_number": "219-510-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S HURSTBOURNE PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402997319",
            "telephone_number": "502-709-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PATRICK",
        "middle_name": "ANTHONY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "11372",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "11372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Ritchie Kelly, MHS, PT
• John Kip Kelly, AU.D.,PH.D.
• Joshua Britt Kelly, SLP
• Lawrence R Kelly, M.D.
• Pamela Kelly
• Robert Douglas Kelly, MD
• Sean Michael Kelly, LPCC
• Thomas John Kelly, M.D.
• Trace Kelly, FNP-C, DC
• Chrystal Leanette Kelmanson, APRN

• Dentist in Louisville, KY
• Providers in Louisville, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.