Dr. Paul Michael Kelley, D.D.S.
Dentist, General Practice in Waverly, OH. Individual provider (NPI-1).
NPI number1790791895
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1790791895
- Entity type
- Individual (NPI-1)
- Name
- Dr. Paul Michael Kelley
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 31, 2006
- Last updated
- Jul 8, 2007
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 |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 17366 | OH | Yes |
Practice location
48 Overlook DrWaverly, OH 45690-9042
Phone 740-289-4218
Mailing address
48 Overlook DrWaverly, OH 45690-9042
Phone 740-289-4218
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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.
Other General Practice Dentistry providers in Waverly, OH
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All 6 General Practice Dentistry providers in Waverly · All 759 providers in Waverly
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