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Active NPI 1033907423 Individual Practitioner Male Practitioner

Dr. Roah Kelly , DMD

Dentist - General Practice • Catoosa, OK

Professional Overview & Biography Verified Profile Summary

Dr. Roah Kelly, DMD is a registered healthcare professional specializing in Dentist - General Practice in Catoosa, OK. Practice services are available at 2036 S MILLER LN STE B under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2036 S Miller Ln Ste B

Catoosa, OK 740151539

Telephone 9189377660

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Catoosa, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.8 Yrs
Regional Practice Density
16 Specialists

Practicing in Catoosa, OK (1496 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

CMS Verified: 2025-04-27
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OK 8066

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.

Practice Associates & Co-Workers

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

6 Associated Practitioners
Dr. Austin Tolbert , DDS

Dentist - General Practice

NPI 1033953625

Doctor of Dental Surgery

Shaun Chacko

Dentist - General Practice

NPI 1427839315
Dr. Rafael Morales , DMD

Dentist - General Practice

NPI 1508541251

Doctor of Dental Medicine

Taylor Bonnewitz

Dentist - General Practice

NPI 1679424055
NPI 1902596570

Doctor of Dental Medicine

Dr. Tyler Snyder , DMD

Dentist - General Practice

NPI 1932997327

Doctor of Dental Medicine

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active April 28, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location April 28, 2025

Registered at 2036 S MILLER LN STE B, CATOOSA, OK 740151539 (Tel: 9189377660)

📍
Updated Business Mailing Address April 28, 2025

Registered at 16204 S 89TH EAST AVE, BIXBY, OK 740084493 (Tel: 8018842460)

👤
Provider Name / Credentials Updated April 28, 2025

Recorded as ROAH KELLY, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 28, 2025

Dentist (License #8066 in OK)

🟢
Initial NPI Registration & Enumeration April 28, 2025

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: 1033907423
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 28, 2025
Last Update: April 28, 2025
Sole Proprietor: No

Mailing Address

16204 S 89th East Ave

Bixby, OK 740084493

Phone: 8018842460

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.