DR. RANDALL SHAWN KELLY (NPI# 1376632430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376632430 |
| Entity Type | Individual |
| Full Name | DR. RANDALL SHAWN KELLY |
| Credential | D.D.S. |
| Practice Address |
700 Sunrise Ave Suite E Roseville CA 95661-4561 |
| Practice Telephone | 9167731122 |
| Mailing Telephone | 9167731122 |
| Mailing Fax Number | 9167733528 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2017-04-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
29984 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922393974 | Randall Douglas Kelly | Physician Assistant | 114 E 16th Ave, Eugene, OR 97401-4033 | 2011-06-16 |
| 1851374946 | Randall Kelly | Obstetrics & Gynecology | 701 W 5th St, Odessa, TX 79763-4206 | 2005-11-22 |
| Street Address |
700 SUNRISE AVE SUITE E |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95661-4561 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912441064 | Shawn Kelly Dds Inc | Durable Medical Equipment & Medical Supplies | 700 Sunrise Ave, Suite E, Roseville, CA 95661-4561 | 2016-12-08 |
| 1164803151 | Zinmar Ma | Emergency Medicine | 700 Sunrise Ave, Roseville, CA 95661-4561 | 2015-06-15 |
| 1326242348 | Kathryn Ann Moore | Dentist | 700 Sunrise Ave, #c, Roseville, CA 95661 | 2007-06-13 |
| 1184828113 | Sydney J Moore | Dentist | 700 Sunrise Ave, # C, Roseville, CA 95661 | 2007-06-13 |
| 1669699930 | Robert Arthur Allen | Clinical Neuropsychologist | 700 Sunrise Ave, Suite B, Roseville, CA 95661-4561 | 2007-04-19 |
| 1184786345 | Sacramento Family Medical Clinic Inc. | Family Medicine | 700 Sunrise Ave, Suite N, Roseville, CA 95661-4561 | 2006-12-14 |
| 1164593182 | Ronald D Greenwood Md Inc | Pediatrics | 700 Sunrise Ave, Suite N, Roseville, CA 95661 | 2006-11-13 |
| 1043381510 | Steven Natzel | Chiropractor | 700 Sunrise Ave, Suite D, Roseville, CA 95661-4561 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
| 1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
| 1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
| 1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
| 1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
| 1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
| 1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
| 1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
| 1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
| 1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
| Find all providers in zip 95661 | ||||
| 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 |
|---|---|---|---|---|
| 1770196891 | Thomas J Hoeffel Dds Pa | Dentist | 2819 Hamline Ave N Ste 104, Roseville, MN 55113-7718 | 2020-08-28 |
| 1023654381 | Daniel Fernando Reyes Sighinolfi | Dentist | 3281 Rock Creek Way, Roseville, CA 95747-7155 | 2019-11-21 |
| 1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
| 1114586203 | Cam Ha | Dentist | 17367 Kershaw St, Roseville, MI 48066-3345 | 2019-06-11 |
| 1861910705 | Rss Laurie Strand Pllc | Dentist | 2375 Fairview Ave N, Roseville, MN 55113-2707 | 2017-08-30 |
| 1326562752 | Fernando Lopez Vargas | Dentist | 4000 Foothills Blvd Ste 126, Roseville, CA 95747-7251 | 2017-07-27 |
| 1942743182 | Sarang Dehghan | Dentist | 3245 Halverson Way, Roseville, CA 95661-4039 | 2016-11-20 |
| 1053760587 | Maichou Yang | Dentist | 700 Sunrise Ave Ste E, Roseville, CA 95661-4561 | 2016-06-06 |
| 1093178055 | Sonny Afshar Dds Inc | Dentist | 2030 Douglas Blvd, Suite 37, Roseville, CA 95661-3855 | 2016-03-29 |
| 1326449984 | Hamzah Alkordy | Dentist | 2424 Professional Dr, Roseville, CA 95661-7773 | 2014-09-14 |
| Find all providers in ROSEVILLE | ||||
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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.