Terry M. Kelly DMD PA

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN11407 Issued in FL

Legal business name

TERRY M. KELLY DMD PA

Practice address

12902 Magnolia Drive
Head and Neck Clinic
Tampa, FL 33612

Phone

(813) 979-3968

Fax

(813) 745-7464

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Terry Michael Kelly, DMD

Title

Owner Dentist

Phone

(813) 745-3968

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Michael Nassif, M.D.

  • Ophthalmology Physician
  • Naples, FL
  • NPI 1982698049
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972640563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S HOWARD AVE STE 106-307",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062473",
            "telephone_number": "813-745-3968",
            "fax_number": "813-745-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 MAGNOLIA DRIVE",
            "address_2": "HEAD AND NECK CLINIC",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-979-3968",
            "fax_number": "813-745-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY M. KELLY DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "813-745-3968",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN11407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tajuanna Monique Terrell
• Tammie Lashaun Terrell, RN
• Armando Terrelonge, LMT
• Terrill Therapy LLC
• Elisa Leian Terrill, LMFT
• Christopher Lee Terry, D.C.
• Devin Kimberly Terry, CNS, RN
• Jennifer Michelle Terry, PHYSICAL THERAPIST
• Kelly Terry, PSYD
• Kristin Joan Terry, M.D.

• Prosthodontics in Tampa, FL
• Providers in Tampa, FL by specialty
• Prosthodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.