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

Dr. Kelly Sue Kennedy, DDS

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1568673366

Dr. Kelly Sue Kennedy, DDS is a Maxillofacial Surgery in Columbus, Ohio. Qualified in 2008, 18 years ago. Practices with Ohio State Dental Faculty Practice Inc, a 4-clinician group and works from 2 locations. Licensed in Ohio.

Years since qualifying
18
Licensed in
OH
In the registry since
2007
Specialties on file
3
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

305 W 12th Ave Dental Faculty Practice
Columbus, OH 43210-1267
Phone: (614) 292-5574
Fax: (614) 292-9472
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 700 Childrens Dr, Columbus, OH 43205-2639 — (614) 722-5651

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence 30.022717 (OH)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 30-022717 (OH)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 2322 (OH)

Record details

NPI number1568673366
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorYes
NPI enumeratedMay 24, 2007
Last updated in NPPESDecember 19, 2019
Certification dateDecember 19, 2019

Medicare enrollment

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

Medicare specialtyMAXILLOFACIAL SURGERY
Also practisesORAL SURGERY
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Ohio State Dental Faculty Practice Inc — 4 clinicians
Accepts Medicare assignment Not indicated

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