MR. PATRICK JAMES KELLY DDS
NPI 1629149372
Dentist in Lincoln Park, MI

Active since November 13, 2006PECOS Enrolled
4009 FORT ST, LINCOLN PARK, MI 48146(313) 928-8555(313) 928-1399 Get Directions Write a Review

NPPES record last updated: March 22, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Patrick James Kelly Dds NPPES

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

MR. PATRICK JAMES KELLY DDS (NPI 1629149372) is an individual dentist in Lincoln Park, Michigan, licensed in Michigan (2901016290) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629149372
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameMR. PATRICK JAMES KELLYCredential: DDS
Location Address4009 FORT STLincoln Park, MI 48146-4110
Mailing Address4009 Fort StLincoln Park, MI 48146-4110 · (313) 928-8555 · Fax (313) 928-1399
Fax(313) 928-1399
Sole ProprietorNo
Enumeration DateNovember 13, 2006
Last NPPES UpdateMarch 22, 2017
NPI 1629149372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License Licensed in MI · 2901016290
Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

4009 FORT ST, Lincoln Park, MI 48146

Other Identifiers 1

Medicaid3334958MI

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mr. Patrick James Kelly Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48146 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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.

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.

Dentist (General Practice)
4009 FORT ST
LINCOLN PARK, MI 48146
Student in an Organized Health Care Education/Training Program
4009 FORT ST
LINCOLN PARK, MI 48146

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 Patrick Kelly's NPI number?

The NPI number for Patrick Kelly is 1629149372. It was assigned to this individual provider in the NPPES registry on November 13, 2006.

Where is Patrick Kelly located?

Patrick Kelly practices at 4009 Fort St, Lincoln Park, MI 48146. The listed phone number is (313) 928-8555.

What is Patrick Kelly's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Patrick Kelly enrolled in Medicare?

Yes. Patrick Kelly is registered in the Medicare PECOS enrollment system.

What insurance does Patrick Kelly accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 8 other insurers list Patrick Kelly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Patrick Kelly was last updated on March 22, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.