Patrick J. Kelly, DDS, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901009898 Issued in MI

Legal business name

PATRICK J. KELLY, DDS, PLLC

Practice address

35992 S Gratiot Ave
Suite a
Clinton Township, MI 48035-1776

Phone

(586) 790-7360

Fax

(586) 790-8860

NPI assigned

Jul 22, 2010

Last updated

Jul 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Patrick James Kelly, DDSNPI 1952333676

Title

Owner

Phone

(586) 790-7360

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patrick James Kelly Sr., D.D.S.

  • General Practice Dentistry
  • Clinton Township, MI
  • NPI 1952333676
  NPD (past) Authorized official

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279756800000",
    "number": "1770896474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35992 S GRATIOT AVE",
            "address_2": "SUITE A",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480351776",
            "telephone_number": "586-790-7360",
            "fax_number": "586-790-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35992 S GRATIOT AVE",
            "address_2": "SUITE A",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480351776",
            "telephone_number": "586-790-7360",
            "fax_number": "586-790-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK J. KELLY, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-790-7360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901009898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siddhe Patel
• Sundeep Harish Patel
• Anne Renee Patlewicz, B.A.
• Theresa Louise Patlewicz, BS, SST
• Joyce E Patouhas, DPM
• Patriots Sleepmanagement PLLC
• Patriots Supply Inc.
• Renee Carmella Patsy, DO
• Santina Sabah Pattah, PHARMD
• Patterson Chiropractic, P.C.

• General Practice Dentistry in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.