Wayne G Kelly DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

037615 Issued in NY

Legal business name

WAYNE G KELLY DDS PC

Practice address

342 Beach 54TH St
Arverne, NY 11692-1782

Phone

(718) 474-0801

Fax

(718) 318-2247

NPI assigned

Jun 10, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Wayne George Kelly, DDS

Title

Dentist/Owner

Phone

(718) 474-0801

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1750762282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 BEACH 54TH ST",
            "city": "ARVERNE",
            "state": "NY",
            "postal_code": "116921782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 BEACH 54TH ST",
            "city": "ARVERNE",
            "state": "NY",
            "postal_code": "116921782",
            "telephone_number": "718-474-0801",
            "fax_number": "718-318-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE G KELLY DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-10",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "718-474-0801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "037615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00778267",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Julie-Ann Theresa Welch, RN
• Marlene Rosemarie Welsh-Hamilton
• Melissa Whetstone
• Marisa C White
• Tiffany S White

• Dentist in Arverne, NY
• Providers in Arverne, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; 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.