Dr. Khadijah Kelly is a Rock Hill, South Carolina based Dentist who is specialized in
General Practice Dentistry. She does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Khadijah Kelly is
10961 for General Practice Dentistry in South Carolina. Her current practice location is
455 Lakeshore Parkway, Rock Hill. Patients can reach her at
803-909-6363.
Dr. Khadijah Kelly is the primary dental care provider for patients of all ages. She is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Dr. Khadijah Kelly speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Dr. Khadijah Kelly |
| Specialization: | Dentist |
| Gender: | Female |
| Credentials: | DDS |
| Accepts Medicare Assignment: | No |
| Practice Address: | 455 Lakeshore Parkway, Rock Hill,
South Carolina, 29730-4205 |
| Phone: | 803-909-6363 |
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 are as mentioned below.
| NPI Number: | 1730868902 |
| NPI Enumeration Date: | 14 Jul, 2023 |
| NPI Last Update On: | 31 Mar, 2025 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Khadijah Kelly are as mentioned below.
| License Number | Specialization | State | Status | |
| 10961 | General Practice Dentistry | South Carolina | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Khadijah Kelly such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| ZX0962 | Medicaid | South Carolina | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 2043 Morton St,
Charlotte, North Carolina |
| Zip: | 28208-5564 |
| Phone Number: | 678-913-8276 |
Patients can reach Dr. Khadijah Kelly at
455 Lakeshore Parkway, Rock Hill, South Carolina or can
call to book an appointment on 803-909-6363.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.