MATTHEW DIXON KELLY
NPI 1699061523
Dentist in Page, AZ

Q: What is Matthew Kelly's NPI number?

The NPI number for Matthew Kelly is 1699061523. It was assigned to this individual provider in the NPPES registry on June 20, 2011. The provider is also known as Matthew D Kelly Dmd.

Q: What is Matthew Kelly's specialty?

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

Q: Is Matthew Kelly enrolled in Medicare?

No. Matthew Kelly has opted out of Medicare through August 25, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Matthew Kelly was last updated on June 20, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 June 20, 2011Opted out of Medicare · through Aug 25, 2027

112 SIXTH AVENUE, PAGE, AZ 86040(928) 645-3206(928) 645-9139 Get Directions Write a Review

NPPES record last updated: June 20, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Matthew Dixon Kelly NPPES

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

MATTHEW DIXON KELLY (NPI 1699061523) is an individual dentist in Page, Arizona, licensed in Arizona (D008232) and active in the NPI registry since June 2011. He has opted out of Medicare through August 25, 2027.

NPPES Registry Identity

NPI1699061523

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameMATTHEW DIXON KELLY

Location Address112 SIXTH AVENUEPage, AZ 86040-1956

Mailing AddressPo Box 1956Page, AZ 86040-1956 · (928) 645-3206 · Fax (928) 645-9139

Phone(928) 645-3206

Fax(928) 645-9139

Sole ProprietorYes

Enumeration DateJune 20, 2011

✔ NPI 1699061523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in AZ · D008232

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.

112 SIXTH AVENUE, Page, AZ 86040

Open in Google Maps ↗

Other Names 1

Professional Name (2)Matthew D Kelly Dmd

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Matthew Dixon Kelly 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 August 25, 2023 through August 25, 2027.

Opt-Out Effective DateAugust 25, 2023

Opt-Out In Effect ThroughAugust 25, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

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

PAGE DENTAL CENTER

Dentist (General Practice)

112 SIXTH AVENUE
PAGE, AZ 86040

Coconino County (928) 645-3206

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 Matthew Kelly's NPI number?

The NPI number for Matthew Kelly is 1699061523. It was assigned to this individual provider in the NPPES registry on June 20, 2011. The provider is also known as Matthew D Kelly Dmd.

Where is Matthew Kelly located?

Matthew Kelly practices at 112 Sixth Avenue, Page, AZ 86040. The listed phone number is (928) 645-3206.

What is Matthew Kelly's specialty?

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

Is Matthew Kelly enrolled in Medicare?

No. Matthew Kelly has opted out of Medicare through August 25, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Matthew Kelly accept?

Health plans from Blue Cross Blue Shield of Arizona, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Delta Dental of Arizona and 1 other insurer list Matthew 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 Matthew Kelly was last updated on June 20, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.