Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1922167410 Individual Practitioner Female Practitioner

Dr. Kelly Jo Phillips , DDS

Dentist - General Practice • Worthington, MN

Professional Overview & Biography Verified Profile Summary

Dr. Kelly Phillips, DDS is a registered healthcare professional specializing in Dentist - General Practice in Worthington, MN. Practice services are available at 1316 MCMILLAN ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1316 Mcmillan St

Worthington, MN 561871646

Telephone 5073765525
Fax 5073763796
Associated Practice Facility / Clinic
🏢 Friendly Dental Facility NPI 1770672958

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Worthington, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 33.3 Yrs
Regional Practice Density
8 Specialists

Practicing in Worthington, MN (2262 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MN D12193

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
687623400 (MN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Dr. Jerry Johnson , DDS

Dentist - General Practice

NPI 1316975568

Doctor of Dental Surgery

Angela Johnson , RDH

Dental Hygienist

NPI 1487830360

Registered Dental Hygienist

Alyssa Nordell

Dental Hygienist

NPI 1578749743
Dr. Valerie Vadnais , DMD

Dentist - General Practice

NPI 1588786164

Doctor of Dental Medicine

NPI 1902414311

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 15, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location October 15, 2012

Registered at 1316 MCMILLAN ST, WORTHINGTON, MN 561871646 (Tel: 5073765525)

📍
Updated Business Mailing Address October 15, 2012

Registered at 1316 MCMILLAN ST., PO BOX 727, WORTHINGTON, MN 56187 (Tel: 5073765525)

👤
Provider Name / Credentials Updated October 15, 2012

Recorded as KELLY PHILLIPS, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 15, 2012

Dentist (License #D12193 in MN)

🟢
Initial NPI Registration & Enumeration December 08, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1922167410
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 08, 2006
Last Update: October 15, 2012
Sole Proprietor: No

Mailing Address

1316 Mcmillan St., Po Box 727

Worthington, MN 56187

Phone: 5073765525

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.