MR. KELLY B BOSWORTH (NPI# 1174615306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174615306 |
| Entity Type | Individual |
| Full Name | MR. KELLY B BOSWORTH |
| Credential | DDS 9311 |
| Practice Address |
24000 Hwy 7 Suite 120 Kelly Bosworth Family Dentistry Shorewood MN 55331 |
| Practice Telephone | 9524744123 |
| Practice Fax Number | 9524013482 |
| Mailing Telephone | 9524744123 |
| Mailing Fax Number | 9524013482 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 9311 | MN | Dental Providers |
| Street Address |
24000 HWY 7 SUITE 120 KELLY BOSWORTH FAMILY DENTISTRY |
| City | SHOREWOOD |
| State | MN |
| Zip Code | 55331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487037040 | Alyssa Jayne Isaacson | Chiropractor | 24000 Hwy 7, Suite 215, Shorewood, MN 55331 | 2015-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609432798 | Christina Mccullough Dds Pllc | Dentist | 2455 Shadywood Road, Orono, MN 55331 | 2019-05-14 |
| 1558854042 | Melissa Ann Morency | Massage Therapist | 23505 County Road 19, Excelsior, MN 55331 | 2018-06-11 |
| 1801388475 | Susanne B Kanter | Physical Therapist | 23490 Mn-7, Shorewood, MN 55331 | 2018-05-30 |
| 1518367440 | Danielle Marie O'connell | Chiropractor | Knewtson Health Group, 23505 Smithtown Rd Suite 100, Excelsior, MN 55331 | 2014-08-28 |
| 1467893511 | Allison Scott | Pharmacist | 23800 Mn Hwy 7, Shorewood, MN 55331 | 2013-07-17 |
| 1417204751 | Minnetonka Psychology and Wellness | Marriage & Family Therapist | 19765 Highway 7, Suite 203, Shorewood, MN 55331 | 2012-08-06 |
| 1952623456 | Virginia Lee Sievers Green | Occupational Therapist | 464 2nd Street, Suite 105, Excelsior, MN 55331 | 2010-02-24 |
| 1497980163 | Harmonia Health Care | Home Health | 3121 Pillsbury Ave S, Minneapolis, MN 55331 | 2009-05-24 |
| 1831352731 | Kelli J O'shea | Occupational Therapist | 19685 Hwy 7, Shorewood, MN 55331 | 2008-07-10 |
| 1922295658 | Nueva Era Healthcare Services, Inc. | Home Health | 5667 Wood Duck Circle, Shorewood, MN 55331 | 2007-09-26 |
| Find all providers in zip 55331 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558830794 | Sidharth Mohan | Dentist | 964 Brookforest Ave, Shorewood, IL 60404-8807 | 2018-11-16 |
| 1215416201 | Affordable Dentures & Implants - Shorewood, P.C. | Dentist | 578 Brookforest Ave, Shorewood, IL 60404-9706 | 2018-08-09 |
| 1861868671 | Natalie Salman | Dentist | 1007 W Jefferson St, Shorewood, IL 60404-9777 | 2015-08-15 |
| 1578899720 | James Kircher | Dentist | 2608 E Beverly Rd, Shorewood, WI 53211-2436 | 2009-10-22 |
| 1730312455 | Rahul Ved Prakash | Dentist | 964 Brook Forest Ave, Troy Dental, Shorewood, IL 60404-8807 | 2009-08-27 |
| 1932386810 | Advanced Family Dental of Shorewood, P.C. | Dentist | 150 N Brook Forest Drive, Shorewood, IL 60404 | 2008-01-23 |
| 1124246756 | Alexander Grabavoy | Dentist | 1007 W. Jefferson Street, Shorewood, IL 60404 | 2007-04-20 |
| 1841816444 | Hannah G Draver | Dentist | 3970 N Oakland Ave Ste 403, Shorewood, WI 53211-2265 | 2020-06-19 |
| 1477969251 | Britly Barton | Dentist | 607 W Jefferson St, Shorewood, IL 60404-3700 | 2014-07-01 |
| 1336589134 | Carolyn Griffin | Dentist | 1720 E Lake Bluff Blvd, Shorewood, WI 53211-1563 | 2013-06-26 |
| Find all providers in SHOREWOOD | ||||
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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.