Kelsey Lynn Dagenhart, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

042602 Issued in PA

Practice address

907 Chester Pike
Sharon Hill, PA 19079-1411

Phone

(610) 586-3500

NPI assigned

Apr 11, 2018

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1871090373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2364 E NORRIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191251929",
            "telephone_number": "715-304-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 CHESTER PIKE",
            "city": "SHARON HILL",
            "state": "PA",
            "postal_code": "190791411",
            "telephone_number": "610-586-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGENHART",
        "first_name": "KELSEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "042602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shalaysia N Coles, LPN
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• Denise Copeland
• Christiian Storm Credle, PSYD
• Cynthia Home Healthcare Agency LLC
• Daylight Intervention
• Deborah Lawson Enterprises LLC (Deborah Morgan)
• Deanna Louise Dehaas, PSYD
• Del Community Home Care Agency, LLC
• Delaware Valley Community Health, Inc. (Fairmount Primary Care Center at Sharon Hill-Delaware County)

• General Practice Dentistry in Sharon Hill, PA
• Providers in Sharon Hill, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.