MEDICARE: WESLEY CHAPEL DENTAL CARE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1871452490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESLEY CHAPEL DENTAL CARE, PLLC

Provider Business Mailing Address
First Line	:	33785 WESLEY CHAPEL BLVD STE B&C
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-4249
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	33785 WESLEY CHAPEL BLVD STE B&C
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-4249
Country	:	US
Telephone Number	:	813-815-7800
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PETER KELLY
Credential	:
Telephone Number	:	410-303-1528

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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