DR. DAVID RANDOLPH KELLY DDS NPI 1124048491

NPI Information

  • NPI: 1124048491
  • Provider Name: DR. DAVID RANDOLPH KELLY, DDS
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 1941 EUCLID AVE
    BRISTOL, VA
    ZIP 24201
  • Phone: (276) 669-0112

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NPI Details

DR. David Randolph Kelly, DDS is a general practice dentist in Bristol, VA. 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. David Randolph Kelly, DDS NPI is 1124048491. 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:

1941 EUCLID AVE
BRISTOL, VA
ZIP 24201-607
Phone: (276) 669-0112
Fax: (276) 669-6922

The enumeration date for this NPI number is 7/20/2006 and was last updated on 7/8/2007.

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 Practice0401006167VIRGINIAYes

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
19178719MEDICAIDVIRGINIA
20064919OTHERTENNESSEEBCBS
3021225OTHERANTHEM

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: 11/21/2025

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