Joseph C Kelly Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

BK5934612 Issued in DE

Practice address

2205 Silverside Road
Wilmington, DE 19810

Phone

(302) 475-5555

Fax

(302) 475-5861

NPI assigned

Aug 25, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DE

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

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.

• Joseph C. Kelly, Jr., D.D.S.,PA

  • General Practice Dentistry
  • Wilmington, DE
  • NPI 1760786404
  NPD Authorized official

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1942318555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 SILVERSIDE ROAD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19810",
            "telephone_number": "302-475-5555",
            "fax_number": "302-475-5861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 SILVERSIDE ROAD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19810",
            "telephone_number": "302-475-5555",
            "fax_number": "302-475-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOSEPH",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "G1-0001086",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DE",
            "license": "BK5934612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760786404",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000037979",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily R Keller, CRNP
• G. William Keller, D.D.S.
• Nicole Keller, LCSW
• Kathleen T Kelley
• Robin D. Kelley, APRN
• Joseph P Kelly, OTRLCHT
• Karen Maureen Kelly, M.D.
• Karen P Kelly, PHD
• Lauren M Kelly
• Lindsay Helen Kelly, NP

• Dentist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Dentist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.