JACK KELLY DMD
NPI 1679032452
Student in an Organized Health Care Education/Training Program in Waco, TX
About Jack Kelly Dmd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACK KELLY DMD (NPI 1679032452) is an individual student in an organized health care education/training program in Waco, Texas and active in the NPI registry since March 2019.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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.
WACO, TX 76704
WACO, TX 76704
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 Jack Kelly's NPI number?
The NPI number for Jack Kelly is 1679032452. It was assigned to this individual provider in the NPPES registry on March 19, 2019.
Where is Jack Kelly located?
Jack Kelly practices at 609 Elm St, Waco, TX 76704. The listed phone number is (254) 313-6960.
What is Jack Kelly's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
What insurance does Jack Kelly accept?
Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 7 other insurers list Jack 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 Jack Kelly was last updated on March 19, 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.
# Jack Kelly, DMD · NPI 1679032452
Student in an Organized Health Care Education/Training Program provider in Waco, Texas. Individual provider, active in the CMS NPPES registry since March 19, 2019.
## Identity
- **NPI:** 1679032452 (Entity type: Individual)
- **Enumerated:** March 19, 2019
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 609 ELM ST, Waco, TX 76704-2516
- **Phone:** (254) 313-6960
## Record status
- **NPPES last updated:** March 19, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1679032452) · Data from the CMS NPPES public registry.