Michael E. Kellam DMD, PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5252 Issued in AL

Legal business name

MICHAEL E. KELLAM DMD, PC

Practice address

1064 Industrial Pkwy
Saraland, AL 36571-3720

Phone

(251) 675-8150

Fax

(251) 675-8152

NPI assigned

Mar 16, 2009

Organization subpart

No

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

Authorized official

Name

Michael E Kellam, DMDNPI 1851491765

Title

DMD, Practice Owner

Phone

(251) 675-8150

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

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

• Michael Edward Kellam, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Saraland, AL
  • NPI 1851491765
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1750522041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 INDUSTRIAL PKWY",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365713720",
            "telephone_number": "251-675-8150",
            "fax_number": "251-675-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 INDUSTRIAL PKWY",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365713720",
            "telephone_number": "251-675-8150",
            "fax_number": "251-675-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E. KELLAM DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "KELLAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DMD, PRACTICE OWNER",
        "authorized_official_telephone_number": "251-675-8150",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "5252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009937656",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "515-11923",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin N McAdams, PA-C
• Hayley Rowe McCarron, PHARMD
• Debbie McCastlain, PHARM.D.
• Mark A. McDaniel, MD
• Marissa La'Shae McManus, CD
• Natrell Mitchell
• Chris Tyler Moberg II, PHARMD
• Mobile Infirmary Association
• Mobile Pediatric Clinic LLC
• Neighbors & Associates

• Oral and Maxillofacial Surgery (Dentist) in Saraland, AL
• Providers in Saraland, AL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.