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Contact Information

TIMOTHY M. KELLY, DMD, PA
1441 CARLISLE BLVD NE
SUITE D
ALBUQUERQUE, NM87110-5610
 Phone: 505-256-1770
 Fax: 505-255-0220
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dental Public Health

1223D0001X
 

Customized Equipment

332BC3200X 87 All Other Suppliers
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for TIMOTHY M. KELLY, DMD, PA

NPI Number 1558736991
LBN Legal business name TIMOTHY M. KELLY, DMD, PA
Authorized official TIMOTHY KELLY - (OWNER/DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 12/10/2015
Last updated 02/19/2021 - About 5 years ago
Identifiers
NM License # 1413
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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