Douglas Alan Kellogg, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5307 Issued in NC

Practice address

2733 Horse Pen Creek Rd
Suite 107
Greensboro, NC 27410-8399

Phone

(336) 854-9270

Fax

(336) 854-5628

NPI assigned

Feb 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

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.

• East Carolina University

  • Family Medicine Physician
  • Greenville, NC
  • NPI 1972551919
  Medicare reassignment NPD
• Douglas a Kellogg DDS PA

  • Dental Clinic/Center
  • Greensboro, NC
  • NPI 1730351917
  NPD (past) Authorized official
• East Carolina University

  • Internal Medicine Physician
  • Greenville, NC
  • NPI 1043260474
  NPD
• East Carolina University

  • Dentist
  • Greenville, NC
  • NPI 1669750014
  NPD
• William B Gross DDS of Greensboro LLC

  • General Practice Dentistry
  • Greensboro, NC
  • NPI 1770050544
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922142249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2733 HORSE PEN CREEK RD",
            "address_2": "SUITE 107",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274108399",
            "telephone_number": "336-854-9270",
            "fax_number": "336-854-5628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2733 HORSE PEN CREEK RD",
            "address_2": "SUITE 107",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274108399",
            "telephone_number": "336-854-9270",
            "fax_number": "336-854-5628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "DOUGLAS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "5307",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachelle Kelley, PHARMD
• Suzanne Marie Kelley, COTA
• Kellin Foundation
• Kellin Foundation
• Kellin, PLLC
• Andrew Wayne Kelly, DDS
• Chenay A Kelly
• Elizabeth Kelly
• Hailey Seaver Kelly, PHARMD
• Krystle Kelly, NP

• General Practice Dentistry in Greensboro, NC
• Providers in Greensboro, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.