Individual provider Active NPI

Mary K Casey-Kelly, DDS, MPH

  • General Practice Dentistry
  • Oklahoma City, OK
National Provider Identifier
1790720068
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4749 Issued in OK
Practice address
1111 N Lee Ave
Oklahoma City, OK 73103-2600
Phone
(405) 231-8796
Fax
(405) 236-2094
NPI assigned
Jun 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4749 OK Primary

Addresses

Primary practice location

1111 N Lee Ave
Oklahoma City, OK 73103-2600

Mailing address

1111 N Lee Ave
Oklahoma City, OK 73103-2600
Phone (405) 231-8796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4749OKMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1790720068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N LEE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032600",
            "telephone_number": "405-231-8796",
            "fax_number": "405-236-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N LEE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032600",
            "telephone_number": "405-231-8796",
            "fax_number": "405-236-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY-KELLY",
        "first_name": "MARY",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "DDS, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.