Diane C Kelly Dmd, Pc is a Pediatric Dental Clinic in Gainesville, Georgia. It is located at 655 Jesse Jewell Pkwy Se, Gainesville, GA and its contact number is 770-539-9110. The authorized person for Diane C Kelly Dmd, Pc is Diane C Kelly
who is Owner - And Provider of the clinic and their contact number is 678-714-7011. The primary license number for Diane C Kelly Dmd, Pc is DNO12082 (Pediatric Dentistry) in Georgia.
Diane C Kelly Dmd, Pc Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Diane C Kelly Dmd, Pc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Diane C Kelly Dmd, Pc |
| Specialization: | Pediatric Dentistry |
| Clinic Address: | 655 Jesse Jewell Pkwy Se, Gainesville,
Georgia, 30501 |
| Phone: | 770-539-9110 |
| Fax: | 678-714-8388 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Diane C Kelly |
| Position: | Owner - And Provider |
| Contact Number: | 678-714-7011 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Diane C Kelly Dmd, Pc clinic are as mentioned below.
| NPI Number: | 1740452465 |
| NPI Enumeration Date: | 02 Apr, 2008 |
| NPI Last Update On: | 19 Aug, 2008 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Diane C Kelly Dmd, Pc are as mentioned below.
| Specialization | License Number | State | Status | |
| Pediatric Dentistry | DNO12082 | Georgia | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 186794814A | Medicaid | Georgia | |
| 191450941A | Medicaid | Georgia | |
| 390489607J | Medicaid | Georgia | |
| 000046582Y | Medicaid | Georgia | |
| 919057925B | Medicaid | Georgia | |
| 514725717B | Medicaid | Georgia | |
| 000851727B | Medicaid | Georgia | |
| 609963109E | Medicaid | Georgia | |
| 218323780A | Medicaid | Georgia | |
| 609963109L | Medicaid | Georgia | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Diane C Kelly Dmd, Pc
655 Jesse Jewell Pkwy Se,
Gainesville, Georgia |
| Zip: | 30501 |
| Phone Number: | 770-539-9110 |
| Fax Number: | 678-714-8388 |
Patients can reach Diane C Kelly Dmd, Pc at
655 Jesse Jewell Pkwy Se, Gainesville, Georgia or can
call to book an appointment on 770-539-9110.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.