DR. KELLY SUE KENNEDY (D.D.S.) – Oral & Maxillofacial Surgery (D.M.D.), NPI 1568673366
Oral & Maxillofacial Surgery (D.M.D.)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
74 ORAL SURGERY in OH
Provider Addresses for DR. KELLY SUE KENNEDY (D.D.S.)
700 Childrens Dr
Columbus, OH 432052639
Phone: (614) 722-5651
Fax: (614) 355-4497
Type: Location
Ohio State Dental Clinics, 305, West Twelfth Avenue, University District District 4, Columbus, Sharon, Franklin, Ohio, 43210, United States
COLUMBUS, OH 432101267
Phone: (614) 292-5574
Fax: (614) 292-9472
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2009-02-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090209000081 | I | Maxillofacial Surgery | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 15 | 13 | $0 |
Insurance plans in this area (ZIP 43205)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| Oral Surgery, Maxillofacial Surgery | OH | |
| - | OH | |
| D E N T I S T | OH | |
| Maxillofacial Surgery, Oral Surgery | OH |
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