Kelly Orthodontics, PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0516191 Issued in NY

Legal business name

KELLY ORTHODONTICS, PC

Practice address

79 Route 59
Suffern, NY 10901

Phone

(845) 357-0200

Fax

(845) 357-0253

NPI assigned

Apr 29, 2008

Organization subpart

Yes

Parent organization

KELLY ORTHODONTICSAs reported in NPPES

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

Authorized official

Name

Dr. Michael W Kelly, DMD

Title

Orthodontist

Phone

(845) 357-0200

Specialties & licenses 1

Addresses

Part of

Kelly Orthodontics PC

Locations

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1528233772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 ROUTE 59",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "10901",
            "telephone_number": "845-357-0200",
            "fax_number": "845-357-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 ROUTE 59",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "10901",
            "telephone_number": "845-357-0200",
            "fax_number": "845-357-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY ORTHODONTICS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KELLY ORTHODONTICS",
        "enumeration_date": "2008-04-29",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "845-357-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "0516191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Renee Kaufman, R.N.
• Davinder Kaur, RN
• Patricia Ann Keenan
• Nechama Keller-Sabel, NPP
• Kate Elizabeth Keller, CNM
• Michael Francis Kelly Jr., 223700000X,22520000X
• Michael William Kelly, DMD
• Naama Kenig, DPT, NCS
• Shira Kenig, MS, OTR/L
• Menuchah Kenner, OTR/L

• Orthodontics and Dentofacial Orthopedics Dentistry in Suffern, NY
• Providers in Suffern, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.