Kelly a. Hennessey D.D.S., PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KELLY A. HENNESSEY D.D.S., PLLC

Doing business as

Manito Family Dentistry

Practice address

3615 S Grand Blvd
Spokane, WA 99203-2624

Phone

(509) 456-8676

Fax

(509) 465-8676

NPI assigned

Mar 9, 2022

Organization subpart

No

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

Authorized official

Name

Kelly A Hennessey, DDS

Title

Dentist/Owner

Phone

(509) 714-5757

Specialties & licenses 1

Addresses

Other names 1

• Manito Family Dentistry Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elleigh Jae Bates, DDS

  • Dentist
  • Spokane, WA
  • NPI 1265201057
  NPD
• Kelly Hennessey Somers, DDS

  • General Practice Dentistry
  • Spokane, WA
  • NPI 1780160333
  NPD

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1710634670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 S GRAND BLVD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992032624",
            "telephone_number": "509-456-8676",
            "fax_number": "509-465-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 S GRAND BLVD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992032624",
            "telephone_number": "509-456-8676",
            "fax_number": "509-465-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY A. HENNESSEY D.D.S., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "HENNESSEY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "509-714-5757",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manito Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kortney Kellogg, PHARMD
• Pamela Kellogg
• Richard E Kellogg, OD
• Susan Kellogg, RPH
• Betty Jane Kellum
• Kelly Ebels Counseling PLLC (Kelly Ebels Counseling)
• Ashana Kelly
• Ciera Kelly
• Cynthia Ann Kelly, PSYD
• Erin Kelly, MA

• Dental Clinic/Center in Spokane, WA
• Providers in Spokane, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.