OrganizationActive
Kelly Family Dentistry
NPI 1619338761 · Dental Clinic/Center · Jackson, MS
Provider details
- NPI number
- 1619338761
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Shenika Kelly, Dentist/Owner(769) 572-4425
- License
- 364412 (MS)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
514 E Woodrow Wilson Ave Ste G
Jackson, MS 39216-4538
Phone: (769) 572-4425
Fax: (844) 270-0967
Street-level locationGet directions
Mailing address
514 E Woodrow Wilson Ave Ste G
Jackson, MS 39216-4538
Registry dates
- Enumerated
- 2016-03-17
- Last updated
- 2016-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.