Individual provider Active NPI

James Kellogg, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Pearl Harbor, HI
National Provider Identifier
1033634043
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
101884 Issued in CA
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

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210713001668 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7012319049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101884CAMDSocial 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

Verify at the official NPI Registry.