KELLY INGRAHAM NPI 1629606199

NPI Information

  • NPI: 1629606199
  • Provider Name: KELLY INGRAHAM
  • Classification: Dentist - 1223P0700X
  • Specialization: Prosthodontics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 200 1ST ST SW
    ROCHESTER, MN
    ZIP 55905
  • Phone: (507) 284-2339

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NPI Details

Kelly Ingraham is a prosthodontics dentist in Rochester, MN with 6 years of experience. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. Kelly Ingraham NPI is 1629606199. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: HARVARD SCHOOL OF DENTAL MEDICINE
Graduation Year:2020

The provider's business location address is:

200 1ST ST SW
ROCHESTER, MN
ZIP 55905-002
Phone: (507) 284-2339

The NPI 1629606199 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (HCPCS:99211)

The enumeration date for this NPI number is 3/31/2020 and was last updated on 1/28/2025.

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
11223P0700XDentistProsthodonticsD14374MINNESOTAYes
21223S0112XDentistOral and Maxillofacial SurgeryD14374MINNESOTANo

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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