DR. KELLIE KENDRICK CLEVELAND DDS
NPI 1265569909
Dentist - General Practice in Flower Mound, TX

Q: What is Kellie Cleveland's NPI number?

The NPI number for Kellie Cleveland is 1265569909. It was assigned to this individual provider in the NPPES registry on February 28, 2007.

Q: What is Kellie Cleveland's specialty?

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

Q: Is Kellie Cleveland enrolled in Medicare?

No. Kellie Cleveland has opted out of Medicare through February 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Kellie Cleveland was last updated on June 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 28, 2007Opted out of Medicare · through Feb 1, 2028

4110 FM 407 STE 150, FLOWER MOUND, TX 75077(940) 455-7004(940) 455-7064 Get Directions Write a Review

NPPES record last updated: June 4, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Kellie Kendrick Cleveland Dds NPPES

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

DR. KELLIE KENDRICK CLEVELAND DDS (NPI 1265569909) is an individual general practice provider in Flower Mound, Texas, licensed in Texas (21699) and active in the NPI registry since February 2007. She has opted out of Medicare through February 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1265569909

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. KELLIE KENDRICK CLEVELANDCredential: DDS

Location Address4110 FM 407 STE 150Flower Mound, TX 75077

Mailing Address4110 Fm 407 Ste 150Flower Mound, TX 75077-7216 · (940) 455-7004 · Fax (940) 455-7064

Phone(940) 455-7004

Fax(940) 455-7064

Sole ProprietorNo

Enumeration DateFebruary 28, 2007

Last NPPES UpdateJune 4, 2019

✔ NPI 1265569909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in TX · 21699

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.

4110 FM 407 STE 150, Flower Mound, TX 75077

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kellie Kendrick Cleveland Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 1, 2016 through February 1, 2028.

Opt-Out Effective DateFebruary 1, 2016

Opt-Out In Effect ThroughFebruary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75077 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kellie Cleveland's NPI number?

The NPI number for Kellie Cleveland is 1265569909. It was assigned to this individual provider in the NPPES registry on February 28, 2007.

Where is Kellie Cleveland located?

Kellie Cleveland practices at 4110 Fm 407 Ste 150, Flower Mound, TX 75077. The listed phone number is (940) 455-7004.

What is Kellie Cleveland's specialty?

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

Is Kellie Cleveland enrolled in Medicare?

No. Kellie Cleveland has opted out of Medicare through February 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kellie Cleveland was last updated on June 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.