Kelly Family And Cosmetic Dentistry
Clinic/Center, Dental in Brighton, MI. Organization (NPI-2).
NPI number1548046576
StatusActive
Last updated in NPPESNov 11, 2023
Details
- NPI
- 1548046576
- Entity type
- Organization (NPI-2)
- Legal business name
- Kelly Family And Cosmetic Dentistry
- Organization subpart
- No
- Enumeration date
- Sep 6, 2023
- Certification date
- Nov 11, 2023
- Last updated
- Nov 11, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
2358 Genoa Business Park DrBrighton, MI 48114-7366
Phone 810-227-4111
Mailing address
2358 Genoa Business Park DrBrighton, MI 48114-7366
Phone 810-227-4111
Authorized official
Brian Kelly
General Dentist
7343539291
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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