Kelly Ann Bateman, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

26371 Issued in TX

Practice address

3205 N. University Drive
Suite B
Nacogdoches, TX 75965

Phone

(936) 657-0110

NPI assigned

Sep 16, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Cementum LLC

  dba Bateman Dental

  • General Practice Dentistry
  • Nacogdoches, TX
  • NPI 1811577455
  NPD Authorized official

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1801104427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 SPRING CREEK DRIVE",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759656985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 N. UNIVERSITY DRIVE",
            "address_2": "SUITE B",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75965",
            "telephone_number": "936-657-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATEMAN",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038488",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "26371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keli Sheree Barrios, WHNP
• Bartlett Counseling PLLC
• Jennifer Nicole Bartlett, LPC
• Amanda Barugh, IBCLC
• Bastion Emergency Physicians, PPLC
• Matthew Eric Bateman, DMD
• Tiffany Batten, APRN, FNP-C
• Nancy Joanne Batzloff, CRNA
• Peter W. Baublet, C.R.N.A.
• Begins With You Case Management Incorporated

• Dentist in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.