Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1790138642 Individual Practitioner Female Practitioner

Dr. Crystal Kelso , DMD

Dentist - General Practice • Bend, OR

Professional Overview & Biography Verified Profile Summary

Dr. Crystal Kelso, DMD is a registered healthcare professional specializing in Dentist - General Practice in Bend, OR. Practice services are available at 62968 OB RILEY RD STE 12 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

62968 Ob Riley Rd Ste 12

Bend, OR 977039443

Telephone 8554336825
Associated Practice Facility / Clinic
🏢 Willamette Dental Facility NPI 1194143065

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Bend, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
72 Specialists

Practicing in Bend, OR (1994 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: 2024-09-27
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OR D10498

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.

Secondary Practice Locations

1105 Se Jetty Ave, #b

Lincoln City, OR 973672632

Phone: 8554336825

Practice Associates & Co-Workers

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

40 Associated Practitioners
NPI 1003268319

Doctor of Dental Medicine

Dr. Jefferson Gourley , DDS

Dentist - Endodontics

NPI 1003941170

Doctor of Dental Surgery

Dr. Jonathan Kim , DDS

Dentist - General Practice

NPI 1013568294

Doctor of Dental Surgery

NPI 1023520574

Doctor of Dental Surgery

Dr. Myriam Hamieh , DMD, MS

Dentist - Orthodontics and Dentofacial Orthopedics

NPI 1023739224

Doctor of Dental Medicine, Master of Science

NPI 1023851755

Doctor of Dental Surgery

Career & Practice History Timeline

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

7 Historical Events
📍
Updated Practice Location September 27, 2024

Registered at 62968 OB RILEY RD STE 12, BEND, OR 977039443 (Tel: 8554336825)

NPI Profile Active July 15, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location July 15, 2016

Registered at 1105 SE JETTY AVE, #B, LINCOLN CITY, OR 973672632 (Tel: 8554336825)

📍
Updated Business Mailing Address July 15, 2016

Registered at 6950 NE CAMPUS WAY, HILLSBORO, OR 971245611 (Tel: 5039522125)

👤
Provider Name / Credentials Updated July 15, 2016

Recorded as CRYSTAL KELSO, DMD

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

Dentist (License #D10498 in OR)

🟢
Initial NPI Registration & Enumeration July 15, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1790138642
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 15, 2016
Last Update: September 27, 2024
Sole Proprietor: No

Mailing Address

6950 Ne Campus Way

Hillsboro, OR 971245611

Phone: 5039522125

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.