Kelley Family Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

D-3719 Issued in ID

Legal business name

KELLEY FAMILY DENTISTRY

Practice address

35 S State St
Preston, ID 83263-1239

Phone

(208) 852-2564

NPI assigned

Mar 26, 2008

Last updated

Mar 26, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Darron Harris Kelley, DDSNPI 1760490890

Title

Ceo

Phone

(208) 852-2564

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Darron Harris Kelley, DDS

  • General Practice Dentistry
  • Preston, ID
  • NPI 1760490890
  NPD (past) Authorized official
• Darrell Byron Kelley, DDS

  • General Practice Dentistry
  • Preston, ID
  • NPI 1962510404
  NPD (past)

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1457523805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 S STATE ST",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631239",
            "telephone_number": "208-852-2564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 S STATE ST",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631239",
            "telephone_number": "208-852-2564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "DARRON",
        "authorized_official_middle_name": "HARRIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-852-2564",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-3719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy D Jensen, RN
• Sarah Jane Jensen, CCC-SLP
• Sheena Jones, LPC, QP
• Justin Carter DDS P.C. (Canyon Creek Dental)
• Shawna Marie Keller, APRN, DNP-FNP-C
• Darrell Byron Kelley, DDS
• Darron Harris Kelley, DDS
• John Thomas Kezele III, CRNA
• Stuart G Knapp, MD
• Julie Kraus, LPC, LSW, SUDC, SSW

• Dentist in Preston, ID
• Providers in Preston, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.