Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kelly Ann Dezura, DMD

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1306009881

Dr. Kelly Ann Dezura, DMD is a Maxillofacial Surgery in Clackamas, Oregon. Graduated from Tufts University School of Dental Medicine in 2008, 18 years ago. Practices with Kaiser Foundation Health Plan of the Northwest, a 1,811-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
18
Trained at
Tufts University School of Dental Medicine
Licensed in
OR
In the registry since
2008
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

10181 SE Sunnyside Rd Otolaryngology (ent)
Clackamas, OR 97015
Phone: (510) 571-4727
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence D9858 (OR)

Record details

NPI number1306009881
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD
Sole proprietorYes
NPI enumeratedJuly 6, 2008
Last updated in NPPESAugust 28, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMAXILLOFACIAL SURGERY
Medical schoolTUFTS UNIVERSITY SCHOOL OF DENTAL MEDICINE
Graduated 2008 (18 years in practice)
Group practice Kaiser Foundation Health Plan Of The Northwest — 1811 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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