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KELLY FAMILY DENTISTRY
NPI 1619338761
Clinic/Center - Dental in Jackson, MS

Active since March 17, 2016
514 E WOODROW WILSON AVE STE G, JACKSON, MS 39216(769) 572-4425(844) 270-0967 Get Directions Write a Review

NPPES record last updated: March 17, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelly Family Dentistry NPPES

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

KELLY FAMILY DENTISTRY (NPI 1619338761) is a healthcare organization registered as a dental in Jackson, Mississippi and active in the NPI registry since March 2016. The organization lists Shenika Kelly, Dentist/owner, as its authorized official.

NPPES Registry Identity

NPI1619338761
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameKELLY FAMILY DENTISTRY
Location Address514 E WOODROW WILSON AVE STE GJackson, MS 39216-4538
Mailing Address514 E Woodrow Wilson Ave Ste GJackson, MS 39216-4538 · (769) 572-4425 · Fax (844) 270-0967
Phone(769) 572-4425
Fax(844) 270-0967
Organization SubpartNo
Authorized OfficialShenika KellyDentist/owner · (769) 572-4425
Enumeration DateMarch 17, 2016
✔ NPI 1619338761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in MS · 364412
514 E WOODROW WILSON AVE STE G, Jackson, MS 39216
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Other Providers at the Same Location NPPES

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

SHENIKA SHAREE KELLY
Dentist (General Practice)
514 E WOODROW WILSON AVE STE G
JACKSON, MS 39216
Hinds County (769) 572-4425

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 Kelly Family Dentistry's NPI number?

The NPI number for Kelly Family Dentistry is 1619338761. It was assigned to this organization in the NPPES registry on March 17, 2016.

Where is Kelly Family Dentistry located?

Kelly Family Dentistry is located at 514 E Woodrow Wilson Ave Ste G, Jackson, MS 39216. The listed phone number is (769) 572-4425.

What is Kelly Family Dentistry's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Kelly Family Dentistry was last updated on March 17, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.