Active NPI
Kelly S. Wells, D.D.S.
- Dentist
- Albuquerque, NM
National Provider Identifier
1801182696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD3497
- Practice address
- 6211 4TH St NW
Suite 13
Albuquerque, NM 87107-5761 - Phone
- (505) 821-5437
- NPI assigned
- Jun 21, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD3497 | NM | Primary |
Addresses
Primary practice location
6211 4TH St NW
Suite 13
Albuquerque, NM 87107-5761
Mailing address
6211 4TH St NW
Suite 13
Albuquerque, NM 87107-5761
Phone (505) 821-5437
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
| License | State | Type | Specialty |
|---|---|---|---|
| DD3497 | NM | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308614400000",
"number": "1801182696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6211 4TH ST NW",
"address_2": "SUITE 13",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871075761",
"telephone_number": "505-821-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6211 4TH ST NW",
"address_2": "SUITE 13",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871075761",
"telephone_number": "505-821-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "KELLY",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-21",
"last_updated": "2011-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD3497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.