Roy William Kelly Jr DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

3944 Issued in NC

Legal business name

ROY WILLIAM KELLY JR DDS PA

Practice address

1601C East Garrison Blvd
Gastonia, NC 28054

Phone

(704) 867-1671

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. R William Kelly Jr., DDS

Title

President Owner

Phone

(704) 867-1671

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kelly and Kelly Other name

Locations

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1942391370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601C EAST GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28054",
            "telephone_number": "704-867-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601C EAST GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28054",
            "telephone_number": "704-867-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROY WILLIAM KELLY JR DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "R WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "704-867-1671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "3944",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "3944",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8994825",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kelly and Kelly",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Doris W Ross, RN
• Tinesella Raynette Ross, MSW, PLCSW, PLCAS
• Vincent Ross, BA
• Reshaune Amanda Rosser, RN,BSN
• Round Table Coaching and Consulting
• Sarah M. Roy, NP
• Michelle Royer
• Katherine B Royston, DC
• Sasha Rozier
• Karen Brown Rubin, PHD

• Dentist in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.