MATTHEW DIXON KELLY (NPI# 1699061523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699061523 |
| Entity Type | Individual |
| Full Name | MATTHEW DIXON KELLY |
| Other Name | MATTHEW D KELLY |
| Practice Address |
112 Sixth Avenue Page AZ 86040-1956 |
| Mailing Address |
Po Box 1956 Page AZ 86040-1956 |
| Practice Telephone | 9286453206 |
| Practice Fax Number | 9286459139 |
| Mailing Telephone | 9286453206 |
| Mailing Fax Number | 9286459139 |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2011-06-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D008232 | AZ | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033465042 | Matthew Kelly | Dentist | 9 E Van Buren St, Millstadt, IL 62260-2009 | 2012-07-27 |
| 1194864298 | Matthew Thomas Kelly | Chiropractor | 4035 Dixie Hwy, Elsmere, KY 41018-1813 | 2007-02-05 |
| 1891860904 | Matthew J Kelly | Family Medicine | 1114 Hickox St, Santa Fe, NM 87505-1088 | 2006-11-22 |
| 1942847918 | Matthew Spencer Kelly | Optometrist | 317 Clarkson Rd, Ellisville, MO 63011-2271 | 2019-12-09 |
| 1760031256 | Matthew Kelly | Physical Therapist | 463 Tremont St W Ste 100, Port Orchard, WA 98366-3743 | 2019-09-06 |
| 1013400886 | Matthew John Kelly | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2018-06-07 |
| 1891225801 | Matthew Kelly | Hearing Instrument Specialist | 1754 Madison St Ste A, Clarksville, TN 37043-2923 | 2017-06-13 |
| 1003363458 | Matthew P Kelly | Counselor | 14 Jackson St, Northampton, MA 01060-1606 | 2016-09-01 |
| 1013364082 | Matthew Kelly | Internal Medicine | 601 John St # 74, Kalamazoo, MI 49007 | 2016-05-19 |
| 1720432701 | Matthew Ryer Kelly | Student in an Organized Health Care Education/Training Program | 750 E Adams St, Syracuse, NY 13210-2306 | 2016-04-15 |
| Street Address |
112 SIXTH AVENUE |
| City | PAGE |
| State | AZ |
| Zip Code | 86040-1956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164689139 | Page Dental Center | Dentist | 112 Sixth Avenue, Page, AZ 86040-1956 | 2008-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881251437 | Amy Jean Snell | Nurse Practitioner | 501 N. Navajo Dr., Page, AZ 86040 | 2019-05-20 |
| 1740748441 | Cameron Sidney Shick | Pharmacist | 501 N Navajo Drive, Page, AZ 86040 | 2019-03-12 |
| 1891250338 | Samantha Elizabeth Cannavo | Specialist/Technologist | 1801 N Navajo Dr., Page, AZ 86040 | 2019-02-08 |
| 1023593282 | Sally Ann Breen | Nurse Practitioner | 440 N Navajo Drive, Page, AZ 86040 | 2018-10-03 |
| 1114447653 | Naquita Ahern | Physical Therapist | 501 N Navajo Rd, Page, AZ 86040 | 2017-06-26 |
| 1396270443 | Peter Richard Jones | Physical Therapy Assistant | 43 Sixth Ave, Page, AZ 86040 | 2017-04-26 |
| 1407392590 | Lake Powell Dental Center, PC | Dentist | 436 Vista Avenue, Box 1956, Page, AZ 86040 | 2017-01-12 |
| 1992257695 | Theodore Martin | Physical Therapist | 39 6th Avenue, Page, AZ 86040 | 2016-10-28 |
| 1750833539 | Jacqueline Joyce Muthanga Kigundu | Nurse Practitioner | 440 North Navajo Dr, Page, AZ 86040 | 2016-10-27 |
| 1821540899 | George Wertz | Physical Therapist | 39 6th Ave, Page, AZ 86040 | 2016-10-26 |
| Find all providers in zip 86040 | ||||
| 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 |
|---|---|---|---|---|
| 1407392590 | Lake Powell Dental Center, PC | Dentist | 436 Vista Avenue, Box 1956, Page, AZ 86040 | 2017-01-12 |
| 1033242532 | Paul Burton | Dentist | 680 Haul Rd. Ste B, Page, AZ 86040-2369 | 2007-03-13 |
| 1326083577 | Ryan James Robinson | Dentist | 112 6th Ave, Page, AZ 86040-0209 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407456031 | Roger Ryan Roybal, Dds, Pllc | Dentist | 14300 N Northsight Blvd Ste 214, Scottsdale, AZ 85260-3677 | 2020-11-01 |
| 1851990444 | Shaveta Behl | Dentist | 320 E Mcdowell Rd Ste 221, Phoenix, AZ 85004-4516 | 2020-10-23 |
| 1083212575 | Rasha Adil Abduljabbar Al-kaabi | Dentist | 4750 E Union Hills Dr Apt 1076, Phoenix, AZ 85050-3366 | 2020-10-15 |
| 1124625793 | Gilbert Crossroads Kids' Dentists and Orthodontics, LLP | Dentist | 835 S. Gilbert Rd, Suite 104, Gilbert, AZ 85296 | 2020-10-06 |
| 1750998969 | Christie Jacques | Dentist | 7410 E Sutton Dr, Scottsdale, AZ 85260-3915 | 2020-09-30 |
| 1447865480 | Luke Michael Mangelsdorf | Dentist | 2249 Hualapai Mountain Rd Ste 1, Kingman, AZ 86401-8321 | 2020-09-15 |
| 1386258689 | Joshua Dutton | Dentist | 8325 W Happy Valley Rd Unit 100, Peoria, AZ 85383-4361 | 2020-09-03 |
| 1912510678 | Nicholas Ahn | Dentist | 1550 E Campbell Ave Apt 3028, Phoenix, AZ 85014-4271 | 2020-08-24 |
| 1992317143 | Justin S Dole | Dentist | 15125 N Scottsdale Rd Apt 303, Scottsdale, AZ 85254-3157 | 2020-08-19 |
| 1326659087 | Triple Eight Dental Group, Pllc | Dentist | 7910 W Thomas Rd Ste 118, Phoenix, AZ 85033-4830 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
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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.