DR. DAVID RANDOLPH KELLY (NPI# 1124048491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124048491 |
| Entity Type | Individual |
| Full Name | DR. DAVID RANDOLPH KELLY |
| Credential | DDS |
| Practice Address |
1941 Euclid Ave Bristol VA 24201-3607 |
| Practice Telephone | 2766690112 |
| Practice Fax Number | 2766696922 |
| Mailing Telephone | 2766690112 |
| Mailing Fax Number | 2766696922 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
0401006167 | VA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BCBS | 0064919 | 01 |
| VA | 9178719 | 05 | |
| ANTHEM | 021225 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386264760 | David Arnold Kelly | Student in an Organized Health Care Education/Training Program | 417 Ne 1st Ter, Oklahoma City, OK 73104-4056 | 2020-04-25 |
| 1558714238 | David Kelly | Nurse Practitioner | 101 Fornum Dr, Grovetown, GA 30813-2697 | 2016-07-19 |
| 1053727040 | David Adam Kelly | Pharmacist | 1401 S Quintard Ave, Anniston, AL 36201-8248 | 2014-07-10 |
| 1821259722 | David Alexander Kelly | Plastic Surgery | 14275 N 87th St Ste 110, Scottsdale, AZ 85260-3696 | 2008-06-23 |
| 1104014299 | David Charles Kelly Jr. | Radiologic Technologist | 8915 Cherry St, Blue Ash, OH 45242-7846 | 2007-10-15 |
| 1508057845 | David M Kelly | Prosthetist | 1900 116th Ave Ne Ste 201, Bellevue, WA 98004-3013 | 2007-08-01 |
| 1902969843 | David P Kelly | Dentist | 3275 W Ina Rd Ste 101, Tucson, AZ 85741-2152 | 2006-12-19 |
| 1154348753 | David C Kelly | Physician Assistant | Ben Hogan Center, 800 5th Ave., Suite 410, Fort Worth, TX 76104 | 2006-07-17 |
| 1184618910 | David Kelly | Specialist | 275 Sandwich St, Plymouth, MA 02360-2183 | 2005-09-08 |
| 1699308296 | David Andrew Kelly | Counselor | 19411 Helenbirg Rd Ste 101, Covington, LA 70433-5199 | 2020-02-21 |
| Street Address |
1941 EUCLID AVE |
| City | BRISTOL |
| State | VA |
| Zip Code | 24201-3607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700358231 | Just for Grins, PC | Dentist | 1941 Euclid Ave, Bristol, VA 24201-3607 | 2018-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699234716 | Vanessa Ruiz Sutherland | Speech-Language Pathologist | Stonewall Jackson Elementary School, 2045 Euclid Ave, Bristol, VA 24201 | 2019-03-18 |
| 1003394693 | Cplace Bristol Snf, LLC | Clinic/Center | 109 Village Circle, Bristol, VA 24201 | 2018-08-06 |
| 1871001420 | Karen Lavonne Ford | Case Manager/Care Coordinator | 727 Portsmouth Avenue, Bristol, VA 24201 | 2018-01-17 |
| 1558872176 | City of Bristol Va | Ambulance | 211 Lee St, Bristol, VA 24201 | 2017-10-23 |
| 1639396989 | Barry Robert Matheson | Dentist | 817 Gate City Highway, Bristol, VA 24201 | 2007-04-19 |
| 1942338082 | Joann Wolfe Vaughn | Nurse Practitioner | 103 North Street, Ridgeview Pavilion, Bristol, VA 24201 | 2007-03-01 |
| 1003982968 | American Medical Devices, Inc. | Durable Medical Equipment & Medical Supplies | 1788 Island Rd, Bristol, VA 24201 | 2006-11-24 |
| 1134224827 | Theresa D Morris | Licensed Practical Nurse | 510 Cumberland St, Executive Plaza 4th Floor, Bristol, VA 24201 | 2006-09-14 |
| 1083718605 | Tomhave Olson Dental Associates | Dentist | 510 Cumberland St., Executive Plaza, 4th Floor, Bristol, VA 24201 | 2006-09-12 |
| 1972606408 | Terry H Gillenwater | Chiropractor | 2110 Euclid Ave, Bristol, VA 24201 | 2006-09-07 |
| Find all providers in zip 24201 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881163822 | Signature Smile Dental LLC | Dentist | 1212 Veterans Hwy Ste A1, Bristol, PA 19007-2512 | 2018-11-20 |
| 1346757143 | Dental Associates of East Tennessee Pllc | Dentist | 1401 Volunteer Pkwy Ste 3, Bristol, TN 37620-6051 | 2018-01-03 |
| 1396297792 | Aaa Dental LLC | Dentist | 529 Farmington Ave, Bristol, CT 06010-3931 | 2016-11-01 |
| 1346608494 | Gentlecare Dental, LLC | Dentist | 683 Farmington Ave, Store #23, Bristol, CT 06010-3974 | 2016-02-03 |
| 1528479581 | Smiles Dental | Dentist | 87 Central St, Bristol, CT 06010-7046 | 2014-05-13 |
| 1588074025 | Bristol Family Dental, PC | Dentist | 4 Morris Ave, Bristol, CT 06010-4448 | 2014-05-06 |
| 1215369574 | In Kyung Lee | Dentist | 1192 Farmington Ave., Bristol, CT 06010 | 2013-08-08 |
| 1225392855 | Christopher Carle, Dds, PC | Dentist | 1401 Volunteer Pkwy, Bristol, TN 37620-6051 | 2012-06-28 |
| 1457622136 | Vsmiledental Vaishali Suchak LLC | Dentist | 603 Veterans Hwy, Bristol, PA 19007-2504 | 2012-01-26 |
| 1932435476 | Joseph Soliman | Dentist | 1212 Veterans Hwy, A1, Bristol, PA 19007-2512 | 2009-10-18 |
| Find all providers in BRISTOL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.