G Scott Kelly DDS PC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

G SCOTT KELLY DDS PC

Practice address

5 Lowrie Ave
Gladstone, MI 49837-2013

Phone

(906) 428-1923

NPI assigned

Dec 10, 2024

Last updated

Dec 10, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

G Scott Kelly, DDS

Title

Owner

Phone

(906) 428-1923

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• G. Scott Kelly, DDS

  • Dentist
  • Gladstone, MI
  • NPI 1225223506
  NPD

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

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1881400141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LOWRIE AVE",
            "city": "GLADSTONE",
            "state": "MI",
            "postal_code": "498372013",
            "telephone_number": "906-428-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 LOWRIE AVE",
            "city": "GLADSTONE",
            "state": "MI",
            "postal_code": "498372013",
            "telephone_number": "906-428-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G SCOTT KELLY DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "G SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "906-428-1923",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Richard C. Pfotenhauer Family Dentistry
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• David Lee Fairbanks, D.C.
• Margo Irene Fairbanks, D.C.
• Family Roots Chiropractic
• Gallery B Smiles
• Dana Gehlhausen, L.AC.
• Kellie Jean Gillis, DC
• Gladstone Eye Care PC
• Gladstone Pharmacy Inc. (Gladstone Pharmacy)

• Customized Equipment (DME) in Gladstone, MI
• Providers in Gladstone, MI by specialty
• Customized Equipment (DME) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.