Kelly Wilkes Ford, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

3045 Issued in SC

Practice address

321 N Laurel St
Summerville, SC 29483

Phone

(843) 871-6636

Fax

(843) 747-9021

NPI assigned

Jan 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 3, 2017 through May 3, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kelly W. Ford, D.M.D, MH. Spa

  • Periodontics
  • Summerville, SC
  • NPI 1801895115
  NPD (past) Authorized official
• Flowertown Periodontics and Implant Dentistry

  • Periodontics
  • Summerville, SC
  • NPI 1992464176
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760534283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N LAUREL ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29483",
            "telephone_number": "843-871-6636",
            "fax_number": "843-747-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N LAUREL ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29483",
            "telephone_number": "843-871-6636",
            "fax_number": "843-747-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "KELLY",
        "middle_name": "WILKES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "SC",
            "license": "3045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorie Tene Folk, CNA
• Ashley Anna Foote
• For Your Glory Home Care LLC
• Benjamin Robert Ford, MD
• Jessica Ford
• Rhonda Basheba Ford
• Joye Elizabeth Fordham, M.D.
• Sarah Elise Fordham, MSN, APRN, PMHNP-BC
• Forever Crowned Cranial Prosthesis
• Forever Crowned Cranial Prosthesis LLC

• Periodontics in Summerville, SC
• Providers in Summerville, SC by specialty
• Periodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.