Individual provider Active NPI

Kelly Dawn Hostetler, DDS

  • General Practice Dentistry
  • Uniontown, PA
National Provider Identifier
1629041280
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS030210-L Issued in PA
Practice address
665B Cherry Tree LN
Uniontown, PA 15401-8947
Phone
(724) 438-7676
Fax
(724) 438-3060
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS030210-L PA Primary

Addresses

Primary practice location

665B Cherry Tree LN
Uniontown, PA 15401-8947

Mailing address

665B Cherry Tree LN
Uniontown, PA 15401-8947
Phone (724) 438-7676

Other identifiers 1

IdentifierTypeStateIssuer
0018764910001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160127000077 PA Order and Referring Only - General PracticePractitioner - General Practice 4880997733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS030210-LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1629041280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665B CHERRY TREE LN",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154018947",
            "telephone_number": "724-438-7676",
            "fax_number": "724-438-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665B CHERRY TREE LN",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154018947",
            "telephone_number": "724-438-7676",
            "fax_number": "724-438-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSTETLER",
        "first_name": "KELLY",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS030210-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018764910001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniontown, PA

Sources for this page

Verify at the official NPI Registry.