Provider Demographics
NPI:1891852422
Name:KELLEY, DARBY SEXTON (DMD)
Entity Type:Individual
Prefix:DR
First Name:DARBY
Middle Name:SEXTON
Last Name:KELLEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6339 GOLDBRANCH RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-3339
Mailing Address - Country:US
Mailing Address - Phone:803-917-8547
Mailing Address - Fax:
Practice Address - Street 1:16 WEINBERG ST
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102-2629
Practice Address - Country:US
Practice Address - Phone:803-435-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice