Active NPI
James G Vellis, DDS
- Dentist
- Lexington, KY
National Provider Identifier
1699980953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9150
- Practice address
- 800 Rose Street, Room D-432
University of Kentucky College of Dentistry
Lexington, KY 40536-0297 - Phone
- (859) 323-5391
- NPI assigned
- May 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16925 | FL | |
| Dentist | 122300000X | 9150 | KY | Primary |
Addresses
Primary practice location
800 Rose Street, Room D-432
University of Kentucky College of Dentistry
Lexington, KY 40536-0297
Mailing address
800 Rose Street, Room D-432
University of Kentucky College of Dentistry
Lexington, KY 40536-0297
Phone (859) 323-5391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699980953 | Medicaid | KY |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9150 | KY | MD | Dentist |
| 16925 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Petersburg Dental Implant Center | Current | Accepting new patients |
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.
-
- Dental Clinic/Center
- St Petersburg, FL
- NPI 1730923814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351296000000",
"number": "1699980953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 ROSE STREET, ROOM D-432",
"address_2": "UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405360297",
"telephone_number": "859-323-5391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 ROSE STREET, ROOM D-432",
"address_2": "UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405360297",
"telephone_number": "859-323-5391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELLIS",
"first_name": "JAMES",
"middle_name": "G",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-11",
"last_updated": "2012-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "16925",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "9150",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1699980953",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.