John Henry Kelsey, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

021001805 Issued in IL

Practice address

534 W 19TH St
Costa Mesa, CA 92627-2748

Phone

(714) 571-3392

NPI assigned

May 23, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154589307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 CENTRE CT",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926294105",
            "telephone_number": "847-334-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 W 19TH ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272748",
            "telephone_number": "714-571-3392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "332 Skokie Valley Rd",
            "address_2": "Suite # 222",
            "address_purpose": "LOCATION",
            "city": "Highland Park",
            "state": "IL",
            "postal_code": "600354415",
            "country_code": "US",
            "telephone_number": "847-831-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "JOHN",
        "middle_name": "HENRY",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "62784",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021001805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Consuelo Alicia Kellogg
• Kelly K McCann MD Inc
• Brittany Lynne Kelly, LCSW
• Courtney Kelly
• Laurie Kelly
• Brooklynn Kendall
• Quinlyn Kennel
• Lindsey Marie Kenney, OTR/L
• Malia Isabel Kent
• Nicolette Ashley Kent

• Orthodontics and Dentofacial Orthopedics Dentistry in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.