Roy William Kelly Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3944 Issued in NC

Practice address

1725 S New Hope Rd
Gastonia, NC 28054-5850

Phone

(704) 867-1671

Fax

(704) 867-0533

NPI assigned

Aug 10, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• James Houston Kelly DDS PA

  • Dentist
  • Gastonia, NC
  • NPI 1831593656
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218412800000",
    "number": "1700897667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7026 LAKESIDE POINT DR",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280128876",
            "telephone_number": "704-825-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 S NEW HOPE RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545850",
            "telephone_number": "704-867-1671",
            "fax_number": "704-867-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ROY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2008-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "3944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "94825",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8994825",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Kellerman
• Michaela Boyd Kelley, MA, LCMHC
• Alice Ann Kelly, DDS
• Danielle Rae Kelly, PNP-PC
• Roy William Kelly III, D.D.S.
• Aimee Davis Kendall, FNP
• Jayne Kendall, MD
• Theresa Kendall
• Tiffany Donnea Kendall
• Kendrick Counseling & Consultant Agency PLLC

• General Practice Dentistry in Gastonia, NC
• Providers in Gastonia, NC by specialty
• General Practice Dentistry in North Carolina

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