Kevin Daniel Kiely, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0401007303 Issued in VA

Practice address

5408 Discovery Park Blvd
Suite 101
Williamsburg, VA 23188-2893

Phone

(757) 208-0138

Fax

(757) 206-1981

NPI assigned

Aug 31, 2005

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 Jan 1, 2021 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Coastal Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Williamsburg, VA
  • NPI 1497694749
  NPD Authorized official
• Coastal Oral Maxillofacial Surgery & Implants, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Williamsburg, VA
  • NPI 1982973954
  Authorized official Same address or phone

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1699769018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 OAK HOLW",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231888919",
            "telephone_number": "757-208-0138",
            "fax_number": "757-206-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5408 DISCOVERY PARK BLVD",
            "address_2": "SUITE 101",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882893",
            "telephone_number": "757-208-0138",
            "fax_number": "757-206-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELY",
        "first_name": "KEVIN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401007303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelyn Cynthia Kemp, PHD
• Christine Kenfield, CMT
• Ryan Kenney, MD
• Virginia O Kennison, MSPT, OCS
• Ronald V Kidd, PH.D.
• Gloria Kim, PMHNP-BC, FNP-BC
• Karen Emily King, ACNPC-AG
• Brittney Nichole Kirkpatrick, CCC-SLP
• John Vincent Klemer, PT
• Martha Jane Klinger, LPN

• Oral and Maxillofacial Surgery (Dentist) in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.