Active NPI
James Kellogg, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Pearl Harbor, HI
National Provider Identifier
1033634043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 101884
- Practice address
- Naval Health Clinic Hawaii
480 Central Avenue
Pearl Harbor, HI 96860 - Phone
- (808) 474-4242
- NPI assigned
- Aug 10, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 101884 | CA | Primary |
| General Practice Dentistry | 1223G0001X | 101884 | CA |
Addresses
Primary practice location
Naval Health Clinic Hawaii
480 Central Avenue
Pearl Harbor, HI 96860
Mailing address
941 Daly Rd
Kailua, HI 96734-4710
Other practice location 1
PSC 819 Box 18
Fpo, AE 09645-0001
Phone (314) 727-3305
Other practice location 2
1 Jarrett White Rd
Tripler Amc, HI 96859-5001
Phone (559) 970-9597
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210713001668 | CA | Order and Referring Only - Oral Surgery | 7012319049 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101884 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775692800000",
"number": "1033634043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "941 DALY RD",
"city": "KAILUA",
"state": "HI",
"postal_code": "967344710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL HEALTH CLINIC HAWAII",
"address_2": "480 CENTRAL AVENUE",
"city": "PEARL HARBOR",
"state": "HI",
"postal_code": "96860",
"telephone_number": "808-474-4242"
}
],
"practiceLocations": [
{
"address_1": "PSC 819 Box 18",
"address_purpose": "LOCATION",
"city": "FPO",
"state": "AE",
"postal_code": "096450001",
"country_code": "US",
"telephone_number": "314-727-3305",
"country_name": "United States",
"address_type": "MIL"
},
{
"address_1": "1 Jarrett White Rd",
"address_purpose": "LOCATION",
"city": "Tripler Amc",
"state": "HI",
"postal_code": "968595001",
"country_code": "US",
"telephone_number": "559-970-9597",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLOGG",
"first_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-10",
"last_updated": "2026-04-09",
"certification_date": "2026-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CA",
"license": "101884",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "101884",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pearl Harbor, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.