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General NPI Number Information
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NPI Number | 1598375412
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Entity Type | Individual
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Provider Name | ALYSE O'KELLY DMD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 3301 LANCASTER PIKE UNIT 3E-3F
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City | WILMINGTON
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State | DE
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Zip | 19805-1436
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Country | US
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Telephone | 302-803-6560
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Fax |
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Provider Business Mailing Address
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Address Line | 115 ROUND HILL RD
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-2607
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Country | US
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Telephone | 310-418-9518
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS042872
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | G10011591
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License Number State | DE
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