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DIANE C KELLY DMD PC NPI 1740452465


NPI Information

NPI: 1740452465
Provider Name: DIANE C KELLY DMD, PC

Doing Business As: CHILDRENS DENTISTRY AT HAMILTON MILL & GAINESVILLE

Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
655 JESSE JEWELL PKWY SE
GAINESVILLE, GA
ZIP 30501
Phone: (770) 539-9110
Get Directions

DIANE C KELLY DMD, PC is a pediatric dentistry dentist in Gainesville, GA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DIANE C KELLY DMD, PC NPI is 1740452465. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Childrens Dentistry At Hamilton Mill & Gainesville.

The provider's business location address is:

655 JESSE JEWELL PKWY SE
GAINESVILLE, GA
ZIP 30501
Phone: (770) 539-9110
Fax: (678) 714-8388

The provider's authorized official is Diane C Kelly .
The authorized official title is Owner - And Provider and has the following contact phone number (678) 714-7011.

The enumeration date for this NPI number is 4/2/2008 and was last updated on 8/19/2008.


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
11223P0221XDentistPediatric DentistryDNO12082GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1514725717BMEDICAIDGEORGIA
2609963109EMEDICAIDGEORGIA
3000851727BMEDICAIDGEORGIA
4919057925BMEDICAIDGEORGIA
5000046582YMEDICAIDGEORGIA
6186794814AMEDICAIDGEORGIA
7191450941AMEDICAIDGEORGIA
8390489607JMEDICAIDGEORGIA
9609963109LMEDICAIDGEORGIA
10218323780AMEDICAIDGEORGIA

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.