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Active NPI 1356567333 Individual Practitioner Male Practitioner

Dr. Lyle Duane Kelstrom , DDS

Dentist - General Practice • Vancouver, WA

Professional Overview & Biography Verified Profile Summary

Dr. Lyle Kelstrom, DDS is a registered healthcare professional specializing in Dentist - General Practice in Vancouver, WA. Practice services are available at 6202 NE HIGHWAY 99 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6202 Ne Highway 99
#5

Vancouver, WA 986658747

Telephone 3606932592
Fax 3607507939
Associated Practice Facility / Clinic
🏢 Erik Jenson Dmd Pllc Facility NPI 1023840188

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Vancouver, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
158 Specialists

Practicing in Vancouver, WA (3345 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: 2025-02-21
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License WA DE00004874

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

NUCC Taxonomy Code: 122300000X

State License WA DE00004874

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.

Secondary Practice Locations

118 S Parkway Ave

Battle Ground, WA 986049215

Phone: 3603428050

Practice Associates & Co-Workers

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

1 Associated Practitioners
Dr. Erik Jenson , DMD

Dentist - General Practice

NPI 1972024552

Doctor of Dental Medicine

Career & Practice History Timeline

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

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 21, 2025

Dentist (License #DE00004874 in WA)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 6202 NE HIGHWAY 99, #5, VANCOUVER, WA 986658747 (Tel: 3606932592)

📍
Updated Business Mailing Address July 08, 2007

Registered at 6202 NE HIGHWAY 99, #5, VANCOUVER, WA 986658747 (Tel: 3606932592)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as LYLE KELSTROM, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #4874 in WA)

🟢
Initial NPI Registration & Enumeration April 18, 2007

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: 1356567333
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 18, 2007
Last Update: February 21, 2025
Sole Proprietor: Yes

Mailing Address

6202 Ne Highway 99, #5

Vancouver, WA 986658747

Phone: 3606932592

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.