Jennifer Ruth Kelley, DDS is a
Dentist - General Practice based in Granville, New York. Jennifer Ruth Kelley is licensed to practice in New York (license number 04287) and her current practice location is
89 North St, Granville, New York. She can be reached at her office (for appointments etc.) via phone at
(518) 642-2111.
NPI number for Jennifer Ruth Kelley is 1780678748 and her current mailing address is 89 North St, Granville, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1780678748.
Healthcare Provider's Profile
Full Name | Jennifer Ruth Kelley |
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Gender | Female |
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Speciality | Dentist - General Practice |
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Location | 89 North St, Granville, New York |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1780678748
- Provider Enumeration Date: 09/07/2005
- Last Update Date: 06/04/2012
Medical Identifiers
Medical identifiers for Jennifer Ruth Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1780678748 | NPI | - | NPPES |
100-3247 | Medicaid | VT | |
01196652 | Medicaid | NY | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 04287 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jennifer Ruth Kelley is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jennifer Ruth Kelley, DDS 89 North St, Granville, NY 12832-1138 Ph: (518) 642-2111 | Jennifer Ruth Kelley, DDS 89 North St, Granville, NY 12832-1138 Ph: (518) 642-2111 |
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