Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1801282769 Individual Practitioner Female Practitioner

Kelly Rustico

Dentist • Columbus, OH

Professional Overview & Biography Verified Profile Summary

Kelly Rustico is a registered healthcare professional specializing in Dentist in Columbus, OH. Practice services are available at 305 W 12TH AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

305 W 12th Ave

Columbus, OH 432101267

Telephone 6142920880
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Columbus, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.0 Yrs
State Avg: 18.4 Yrs
Regional Practice Density
317 Specialists

Practicing in Columbus, OH (2953 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-10-29
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License OH 30.025097

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License CA DDS102193

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License VA 0401414839

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Secondary Practice Locations

1600 Wilson Blvd Ste 620

Arlington, VA 222092596

Phone: 7035240288

4725 Market St

San Diego, CA 921024715

Phone: 6195152420

305 W 12th Ave

Columbus, OH 432101267

Phone: 6142920880

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1013151943

Doctor of Dental Surgery

Mitchell Thai

Dentist - General Practice

NPI 1013750413
Dr. Diana Mahmoodi , DMD

Dentist - Prosthodontics

NPI 1013807403

Doctor of Dental Medicine

NPI 1023165651

Doctor of Dental Surgery

NPI 1023373701

Doctor of Dental Surgery

Dr. Jennifer Burzynski , DMD

Dentist - Orthodontics and Dentofacial Orthopedics

NPI 1023409349

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

21 Historical Events
📍
Updated Practice Location October 29, 2023

Registered at 305 W 12TH AVE, COLUMBUS, OH 432101267 (Tel: 6142920880)

📍
Updated Business Mailing Address October 29, 2023

Registered at 1189 LEICESTER PL, COLUMBUS, OH 432352181 (Tel: 6144601694)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 29, 2023

Dentist (License #DDS102193 in CA)

📍
Updated Practice Location March 18, 2020

Registered at 1600 WILSON BLVD STE 620, ARLINGTON, VA 222092596 (Tel: 7035240288)

📍
Updated Business Mailing Address March 18, 2020

Registered at 1225 MARTHA CUSTIS DR APT 1119, ALEXANDRIA, VA 223022022 (Tel: 6144601694)

📍
Updated Practice Location March 17, 2018

Registered at 4725 MARKET ST, SAN DIEGO, CA 921024715 (Tel: 6195152420)

📍
Updated Business Mailing Address March 17, 2018

Registered at 8233 STATION VILLAGE LN UNIT 2104, SAN DIEGO, CA 921086584 (Tel: 6144601694)

📍
Updated Practice Location February 25, 2018

Registered at 4725 MARKET ST, SAN DIEGO, CA 921024715 (Tel: 6195152420)

📍
Updated Business Mailing Address February 25, 2018

Registered at 8233 STATION VILLAGE LN UNIT 2104, SAN DIEGO, CA 921086584 (Tel: 6144601694)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 25, 2018

Dentist (License #30.025097 in OH)

NPI Profile Active September 27, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location September 27, 2017

Registered at 305 W 12TH AVE, COLUMBUS, OH 432101267 (Tel: 6142920880)

📍
Updated Business Mailing Address September 27, 2017

Registered at 305 W 12TH AVE, COLUMBUS, OH 432101267 (Tel: (614) 292-0880)

👤
Provider Name / Credentials Updated September 27, 2017

Recorded as KELLY RUSTICO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 27, 2017

Dentist (License #30.025097 in OH)

NPI Profile Active November 15, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location November 15, 2016

Registered at 1215 LEE ST, BOX 800740, CHARLOTTESVILLE, VA 229080816 (Tel: 4349241774)

📍
Updated Business Mailing Address November 15, 2016

Registered at 1215 LEE ST, BOX 800740, CHARLOTTESVILLE, VA 229080816 (Tel: 4349241774)

👤
Provider Name / Credentials Updated November 15, 2016

Recorded as KELLY RUSTICO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 15, 2016

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 07, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Kelly Rustico. Be the first to share your experience!

Sign in to leave a review for Kelly Rustico

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1801282769
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 07, 2015
Last Update: October 29, 2023
Sole Proprietor: No

Mailing Address

1189 Leicester Pl

Columbus, OH 432352181

Phone: 6144601694

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.