NPIMap

Organization Active NPI

Thomas S. Kelly, DDS, Inc.

  • General Practice Dentistry
  • Beachwood, OH
National Provider Identifier
1689884447
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-01-9809 Issued in OH
Legal business name
THOMAS S. KELLY, DDS, INC.
Practice address
3700 Park East Dr
Suite 180
Beachwood, OH 44122-4339
Phone
(216) 464-3777
Fax
(216) 464-3377
NPI assigned
May 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas S Kelly, DDSNPI 1215147079
Title
President
Phone
(216) 464-3777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 30-01-9809 OH Primary

Addresses

Primary practice location

3700 Park East Dr
Suite 180
Beachwood, OH 44122-4339

Mailing address

3700 Park East Dr
Suite 180
Beachwood, OH 44122-4339
Phone (216) 464-3777

National Provider Directory

National Provider Directory

Locations

3700 Park East Dr
Ste 180
Beachwood, OH 44122
Phone (216) 464-3777

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689884447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 PARK EAST DR",
            "address_2": "SUITE 180",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224339",
            "telephone_number": "216-464-3777",
            "fax_number": "216-464-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 PARK EAST DR",
            "address_2": "SUITE 180",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224339",
            "telephone_number": "216-464-3777",
            "fax_number": "216-464-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS S. KELLY, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-464-3777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-01-9809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.