Kelly Family Dental, PC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

KELLY FAMILY DENTAL, PC

Doing business as

Blue Water Dental Care

Practice address

1820 S Arlington Ave
Reno, NV 89509-3309

Phone

(775) 329-8622

NPI assigned

Apr 19, 2019

Organization subpart

No

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

Authorized official

Name

David M Kelly, DDS

Title

President/ DDS

Phone

(734) 777-0289

Specialties & licenses 1

Addresses

Other names 1

• Blue Water Dental Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Daniel France, DDS

  • Dentist
  • Reno, NV
  • NPI 1386654572
  NPD (past)

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555632000000",
    "number": "1497318992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 S ARLINGTON AVE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093309",
            "telephone_number": "775-329-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 S ARLINGTON AVE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093309",
            "telephone_number": "775-329-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY FAMILY DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-19",
        "last_updated": "2019-04-19",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/ DDS",
        "authorized_official_telephone_number": "734-777-0289",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Water Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cheryl Ann Kelley, CTRS
• Francis P Kelley, M.D.
• Matley Rae Kelley, RBT
• Shane Anna Kelley, PHD
• Cheri Kellie
• Kelly Grim
• Kelly King MD PLLC
• Allison Kelly, LSW
• Ann Elizabeth Kelly
• Brianne Marie Kelly, PA

• Public Health Dentistry in Reno, NV
• Providers in Reno, NV by specialty
• Public Health Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.