Cheryl A. Kelley, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

036886 Issued in NY

Practice address

370 White Spruce Blvd
Rochester, NY 14623-1604

Phone

(585) 424-5005

Fax

(585) 475-0096

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477585651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 WHITE SPRUCE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231604",
            "telephone_number": "585-424-5005",
            "fax_number": "585-475-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 WHITE SPRUCE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231604",
            "telephone_number": "585-424-5005",
            "fax_number": "585-475-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "CHERYL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "036886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01039505",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS #",
            "identifier": "9561",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nan Gulnac Keller
• Olivia Keller, DO
• Rita Conti Keller, RPH
• Sara Lynne Keller, PA
• Amanda Kelley, MS, RN, AGCNS-BC
• Christen Noel Kelley, MHC
• Deirdre Mary Kelley, PMHNP
• John Kelley, PT, DPT
• Kristy Kelley, PSYD
• Sheila Phelps Kelley, M.D., PH.D.

• Pediatric Dentistry in Rochester, NY
• Providers in Rochester, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.