W DAVID KELLY (DMD) – Oral and Maxillofacial Surgery (Dentist), NPI 1326041385

W DAVID KELLY (DMD) is a healthcare provider. based in Worcester, Massachusetts. specializing in Oral and Maxillofacial Surgery (Dentist). They hold the professional credentials DMD. They hold a License No. 12222 (MA). The NPI Number for W DAVID KELLY (DMD) is 1326041385

Main info

Male
Sole Proprietor
53 Years Of Experience
Accepts Medicare Assignment
Name
W DAVID KELLY (DMD)
NPI
1326041385
Phone
(508) 799-2550
Address
59 QUINSIGAMOND AVE
Enumeration Date
24 May 2005
Deactivation Date
16 March 2006
Reactivation Date
20 March 2006
Last Update Date
17 February 2012

Doctor Profile

Medical School Name
TUFTS UNIVERSITY SCHOOL OF DENTAL MEDICINE
Secondary Phone
-
Graduation Year
1973 (53 years ago)
PAC ID
9537324488
Professional Enrollment ID
I20120627000794
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:21State licenses:1Digital endpointsOther names

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Provider Addresses for W DAVID KELLY (DMD)

  • 59, Quinsigamond Avenue, Southbridge-Sargent Manufacturing Historic District, Vernon Hill, Worcester, Worcester County, Massachusetts, 01608-2216, United States

    WORCESTER, MA 016101867

    Phone: (508) 799-2550

    Fax: (508) 756-2923

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-06-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120627000794IOral SurgeryMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01610)

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Reviews

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Frequently asked questions

How is W DAVID KELLY (DMD) identified in CMS data?
CMS-hosted NPPES data lists W DAVID KELLY (DMD) with NPI 1326041385.
Can I rely on W DAVID KELLY (DMD) being an active provider?
As of the registry snapshot, W DAVID KELLY (DMD) is marked active.
What healthcare role does W DAVID KELLY (DMD) hold?
Scheduling teams often label W DAVID KELLY (DMD) under Oral and Maxillofacial Surgery (Dentist). Clinical services aligned with this taxonomy classification.
Does W DAVID KELLY (DMD) list a practice location?
Patients near Worcester, Massachusetts may find W DAVID KELLY (DMD) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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