Kelly Lee Kingma, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

08557 Issued in IA

Practice address

3024 Victoria St
Bettendorf, IA 52722-2793

Phone

(563) 332-2447

NPI assigned

Aug 14, 2008

Last updated

Apr 23, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• QC Dental Docs, P.C.

  • General Practice Dentistry
  • Bettendorf, IA
  • NPI 1033344130
  NPD (past)

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1972759546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 HARVEST CIR",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522413466",
            "telephone_number": "319-530-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 VICTORIA ST",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222793",
            "telephone_number": "563-332-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGMA",
        "first_name": "KELLY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Killinger Family Chiropractic
• Lisa Z Killinger, DC
• Gun Hee Kim
• Kimball & Beecher Group LLC (Dentistry Unlimited)
• James Dougherty King, DO
• Lisa Lynn Kinney, L.P.C.
• Bradi Michael Peter Kipper, PA-C
• Richard M Kishiue, MD
• Kivisto Counseling and Therapy LLC (River City Psychotherapy)
• Sarah Kivisto, LISW

• Dentist in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.