Dr Kelly Sue Kennedy, DDS is a medicare enrolled "Oral & Maxillofacial Surgery" provider in Columbus, Ohio. Her current practice location is
305 W 12th Ave, Dental Faculty Practice, Columbus, Ohio. You can reach out to her office (for appointments etc.) via phone at
(614) 292-5574.
Dr Kelly Sue Kennedy is licensed to practice in Ohio (license number 30.022717) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1568673366.
Healthcare Provider's Profile
| Full Name | Dr Kelly Sue Kennedy |
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| Gender | Female |
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| Speciality | |
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| Experience | Years |
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| Location | 305 W 12th Ave, Columbus, Ohio |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Kelly Sue Kennedy attended and graduated from in
NPI Data:
- NPI Number: 1568673366
- Provider Enumeration Date: 05/24/2007
- Last Update Date: 12/19/2019
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Kelly Sue Kennedy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568673366 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 30-022717 (Ohio) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 2322 (Ohio) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | 30.022717 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kelly Sue Kennedy is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kelly Sue Kennedy, DDS
305 W 12th Ave,
Columbus, OH 43210-1267
Ph: (614) 292-5574 | Dr Kelly Sue Kennedy, DDS
305 W 12th Ave, Dental Faculty Practice,
Columbus, OH 43210-1267
Ph: (614) 292-5574 |
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