Constance Ann Kelly

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH00000979 Issued in WA

Practice address

933 E 1St St
Port Angeles, WA 98362-4012

Phone

(360) 452-7891

Fax

(360) 452-8087

NPI assigned

Mar 7, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Constance Ann Jordan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1013664333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W FRONT ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622609",
            "telephone_number": "360-452-7891",
            "fax_number": "360-452-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 E 1ST ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983624012",
            "telephone_number": "360-452-7891",
            "fax_number": "360-452-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CONSTANCE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH00000979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONSTANCE",
            "last_name": "JORDAN",
            "middle_name": "ANN",
            "credential": "DH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Edward Elias Katime, MD
• Hollie Rynerson Kaufman, ARNP
• Shauna Marie Keeley, DPT
• Lynn D Keenan, PHD., LMP
• Arthur J Kehas, MD
• Amy Kemp, SLP
• Paul Leslie Kendrick, DC
• Jacob Kennedy, DDS
• Laura Ann Kennedy, OTR/L
• R Scott Kennedy, MD

• Dental Hygienist in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Dental Hygienist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.