John Robert Kelly, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

008833 Issued in CT

Practice address

263 Farmington Ave
Department of Reconstructive Sciences
Farmington, CT 06030-1615

Phone

(860) 679-3747

Fax

(860) 679-1370

NPI assigned

Jan 3, 2013

Sex

Male

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

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1821334350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "DEPARTMENT OF RECONSTRUCTIVE SCIENCES",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301615",
            "telephone_number": "860-679-3747",
            "fax_number": "860-679-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "DEPARTMENT OF RECONSTRUCTIVE SCIENCES",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301615",
            "telephone_number": "860-679-3747",
            "fax_number": "860-679-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-03",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008833",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "008833",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Joseph Kelley, M.D.
• Michelle Kelley, APRN
• Michael Kellner, M.D.
• Andrew Kelly
• Christopher Kelly
• Martin J. Kelly, LPC
• Martin J. Kelly, PA
• Sharon P. Kelly, APRN
• Shelly-Ann Benesia Kelly, P.A.
• William Taylor Kelsey, PA

• General Practice Dentistry in Farmington, CT
• Providers in Farmington, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; 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.