Provider Type Icon

KELLEY FAMILY DENTISTRY NPI 1457523805


NPI Information

NPI: 1457523805
Provider Name: KELLEY FAMILY DENTISTRY
Classification: Dentist - 122300000X
Entity Type: Organization

CLIA Number: 13D2197916

Address:
35 S STATE ST
PRESTON, ID
ZIP 83263
Phone: (208) 852-2564
Get Directions

KELLEY FAMILY DENTISTRY is a dentist in Preston, ID. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. KELLEY FAMILY DENTISTRY NPI is 1457523805. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

35 S STATE ST
PRESTON, ID
ZIP 83263-239
Phone: (208) 852-2564

The provider's authorized official is Darron Harris Kelley .
The authorized official title is Ceo and has the following contact phone number (208) 852-2564.

The CLIA number assigned to this NPI record is 13D2197916 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/26/2008 and was last updated on 3/26/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentistD-3719IDAHOYes

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: 11/14/2023

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.