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KENNETH R. KELLY, D.D.S, P.C.
NPI 1194734335
Dentist - General Practice in Johnson City, TN

Active since August 05, 2006
402 PRINCETON RD, SUITE A, JOHNSON CITY, TN 37601(423) 283-4175(423) 283-0443 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Kenneth R. Kelly, D.d.s, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH R. KELLY, D.D.S, P.C. (NPI 1194734335) is a healthcare organization registered as a general practice in Johnson City, Tennessee and active in the NPI registry since August 2006. The organization lists Kenneth R. Kelly, President/practioner, as its authorized official.

NPPES Registry Identity

NPI1194734335
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameKENNETH R. KELLY, D.D.S, P.C.
Location Address402 PRINCETON RD, SUITE AJohnson City, TN 37601-2057
Mailing Address402 Princeton Rd, Suite AJohnson City, TN 37601-2057 · (423) 283-4175 · Fax (423) 283-0443
Phone(423) 283-4175
Fax(423) 283-0443
Organization SubpartNo
Authorized OfficialKenneth R. KellyPresident/practioner · (423) 283-4175
Enumeration DateAugust 5, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1194734335 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in TN · DS2230
Definition

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.

402 PRINCETON RD, Johnson City, TN 37601
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LABORATORY CORPORATION OF AMERICA HOLDINGS
Clinical Medical Laboratory
402 PRINCETON RD
JOHNSON CITY, TN 37601
Washington County (423) 854-9340
DR. KENNETH RAYMOND KELLY DDS
Dentist
402 PRINCETON RD, SUITE A
JOHNSON CITY, TN 37601
Washington County (423) 283-4175

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth R. Kelly, D.D.S, P.C.'s NPI number?

The NPI number for Kenneth R. Kelly, D.D.S, P.C. is 1194734335. It was assigned to this organization in the NPPES registry on August 5, 2006.

Where is Kenneth R. Kelly, D.D.S, P.C. located?

Kenneth R. Kelly, D.D.S, P.C. is located at 402 Princeton Rd Suite A, Johnson City, TN 37601. The listed phone number is (423) 283-4175.

What is Kenneth R. Kelly, D.D.S, P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Kenneth R. Kelly, D.D.S, P.C. was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.