Individual provider Active NPI

James Edward Kelley II, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mt Pleasant, SC
National Provider Identifier
1669640793
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
3935 Issued in SC
Practice address
1065 Johnnie Dodds Blvd Ste E
Mt Pleasant, SC 29464-6153
Phone
(843) 856-9323
Fax
(843) 881-1878
NPI assigned
Feb 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 3935 SC Primary

Addresses

Primary practice location

1065 Johnnie Dodds Blvd Ste E
Mt Pleasant, SC 29464-6153

Mailing address

1065 Johnnie Dodds Blvd Ste E
Mt Pleasant, SC 29464-6153
Phone (843) 856-9323

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

LicenseStateTypeSpecialty
3935SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kelley Orthodontics, PC Orthodontics and Dentofacial Orthopedics CurrentSince Dec 6, 2020 Accepting new patients

Locations

1065 Johnnie Dodds Blvd
Ste E
Mt Pleasant, SC 29464
Phone (843) 856-9323

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1669640793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 JOHNNIE DODDS BLVD STE E",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294646153",
            "telephone_number": "843-856-9323",
            "fax_number": "843-881-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 JOHNNIE DODDS BLVD STE E",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294646153",
            "telephone_number": "843-856-9323",
            "fax_number": "843-881-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "SC",
            "license": "3935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.