1215785720 NPI number — DR. AINA KATO KELLY DDS

Table of content: DR. AINA KATO KELLY DDS (NPI 1215785720)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215785720 NPI number — DR. AINA KATO KELLY DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KELLY
Provider First Name:
AINA
Provider Middle Name:
KATO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WEINSTEIN
Provider Other First Name:
AINA
Provider Other Middle Name:
EMILY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1215785720
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5214 VININGS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUBLIN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43016-7149
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-598-7699
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6850 PERIMETER DR STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUBLIN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43016-8051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-761-2600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/09/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  30.027510 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)