Brandon John Kelly, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12709 Issued in MN

Practice address

723 2ND St SW
Rochester, MN 55902-2986

Phone

(507) 281-3926

NPI assigned

Jun 23, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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 and National Provider Directory roles.

• Rochester Dental Professionals LLC

  dba The Dental Doctors

  • Dental Clinic/Center
  • Rochester, MN
  • NPI 1538767876
  NPD Authorized official
• Berg Dental Enterprises, PLLC

  dba The Dental Doctors

  • Dental Clinic/Center
  • Rochester, MN
  • NPI 1639061443
  NPD (past)

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1447488051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 2ND ST SW",
            "address_2": "SUITE 121",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559022986",
            "telephone_number": "507-281-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 2ND ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559022986",
            "telephone_number": "507-281-3926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BRANDON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siobhan Kelley, MT-BC
• Todd Andrew Kellogg, M.D.
• Anna Kellund
• Kelly Dentistry
• Adam Jon Kelly, DMD
• Camry Lynn Kelly, DO
• Casey Kimberly Kelly, MD
• Cecilia Kelly
• Daniel Kelly, M.B, B.CH, BAO
• Ellen Kelly, M.B., B.CH., B.A.O

• General Practice Dentistry in Rochester, MN
• Providers in Rochester, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.