Daniel Reirdon Kelly, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0401008605 Issued in VA

Practice address

905 Rio East Court
Suite B
Charlottesville, VA 22901

Phone

(434) 977-4592

Fax

(434) 977-0675

NPI assigned

Feb 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2015 through Apr 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aum Perio, PLLC

  dba Charlottesville Periodontics & Dental Implants

  • Periodontics
  • Charlottesville, VA
  • NPI 1699615450
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528100047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 RIO EAST COURT",
            "address_2": "SUITE B",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22901",
            "telephone_number": "434-977-4592",
            "fax_number": "434-977-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 RIO EAST COURT",
            "address_2": "SUITE B",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22901",
            "telephone_number": "434-977-4592",
            "fax_number": "434-977-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DANIEL",
        "middle_name": "REIRDON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401008605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca A Keller, DPT
• Meredith Kelley, DNP, FNP-BC
• Ryan Thomson Kellogg, MD
• Brianna Kelly
• Christopher Kelly, LPC
• Ellen Ramos Kelly, DMD
• Gwendolyn Valerie Kelly, M.D.
• Heather C Kelly, MD
• Jennifer Tweel Kelly, MSW
• Padraig Kelly, MD

• Periodontics in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Periodontics in Virginia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.