DR. MATTHEW KELLY D.D.S. NPI 1033465042

NPI Information

  • NPI: 1033465042
  • Provider Name: DR. MATTHEW KELLY, D.D.S.
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 9 E VAN BUREN ST
    MILLSTADT, IL
    ZIP 62260
  • Phone: (618) 476-7828

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NPI Details

DR. Matthew Kelly, D.D.S. is a general practice dentist in Millstadt, IL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Matthew Kelly, D.D.S. NPI is 1033465042. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9 E VAN BUREN ST
MILLSTADT, IL
ZIP 62260-009
Phone: (618) 476-7828

The enumeration date for this NPI number is 7/27/2012 and was last updated on 10/1/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice2012015661MISSOURINo
21223G0001XDentistGeneral Practice019030041ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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