Kelly Ross Carlisle, DMD, BS
NPI 1275097859ActiveIndividual· Dentist· Bountiful, UT
Dentist (DMD, BS) in Bountiful, Utah, licensed in UT, with an NPI issued in January 2019. Part D covered 15 prescriptions written in 2024, 100% of them generic.
Overview
| NPI | 1275097859 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DMD, BS |
| Sole proprietor | No |
| NPI issued | Jan 28, 2019 |
| Last updated in NPPES | Apr 9, 2020 |
| Certified by provider | Apr 9, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 11287528-9922 | UT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 15 · 15 30-day fills |
|---|---|
| Patients | 14 |
| Total drug cost | $70.65 |
| Generic share | 100% of claims |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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