Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124048491 Individual Practitioner Male Practitioner

Dr. David Randolph Kelly , DDS

Dentist - General Practice • Bristol, VA

Professional Overview & Biography Verified Profile Summary

Dr. David Kelly, DDS is a registered healthcare professional specializing in Dentist - General Practice in Bristol, VA. Practice services are available at 1941 EUCLID AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1941 Euclid Ave

Bristol, VA 242013607

Telephone 2766690112
Fax 2766696922
Associated Practice Facility / Clinic
🏢 Just For Grins, Pc Facility NPI 1700358231

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Bristol, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.6 Yrs
Regional Practice Density
9 Specialists

Practicing in Bristol, VA (3535 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 VA 0401006167

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
9178719 (VA)
Commercial Insurance / Payer ID Anthem
021225
Commercial Insurance / Payer ID Bcbs
0064919 (TN)

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 1941 EUCLID AVE, BRISTOL, VA 242013607 (Tel: 2766690112)

📍
Updated Business Mailing Address July 08, 2007

Registered at 1941 EUCLID AVE, BRISTOL, VA 242013607 (Tel: 2766690112)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as DAVID KELLY, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #0401006167 in VA)

🟢
Initial NPI Registration & Enumeration July 20, 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: 1124048491
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 20, 2006
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

1941 Euclid Ave

Bristol, VA 242013607

Phone: 2766690112

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.