Active NPI
Robin Kelly
- Dental Hygienist
- Encinitas, CA
National Provider Identifier
1477886935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 19544
- Practice address
- 1130 2ND St
Encinitas, CA 92024-5008 - Phone
- (760) 943-9994
- Fax
- (760) 736-8740
- NPI assigned
- Sep 15, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 19544 | CA | Primary |
Addresses
Primary practice location
1130 2ND St
Encinitas, CA 92024-5008
Mailing address
150 Valpreda Rd
San Marcos, CA 92069-2973
Phone (760) 736-6700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19544 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252972800000",
"number": "1477886935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 VALPREDA RD",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920692973",
"telephone_number": "760-736-6700",
"fax_number": "760-736-8740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 2ND ST",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920245008",
"telephone_number": "760-943-9994",
"fax_number": "760-736-8740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "ROBIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-15",
"last_updated": "2009-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "19544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encinitas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.