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DR. GWENDOLYN A KELLY D.D.S.
NPI 1316039324
Dentist - General Practice in Inglewood, CA

Active since September 28, 2006Opted out of Medicare · through May 3, 2028
101 N LA BREA AVE, SUITE 506, INGLEWOOD, CA 90301(310) 412-9291(310) 412-1705 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Gwendolyn A Kelly D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GWENDOLYN A KELLY D.D.S. (NPI 1316039324) is an individual general practice provider in Inglewood, California, licensed in California (29936) and active in the NPI registry since September 2006. She has opted out of Medicare through May 3, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1316039324
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. GWENDOLYN A KELLYCredential: D.D.S.
Location Address101 N LA BREA AVE, SUITE 506Inglewood, CA 90301-1769
Mailing Address101 N La Brea Ave, Suite 506Inglewood, CA 90301-1769 · (310) 412-9291 · Fax (310) 412-1705
Phone(310) 412-9291
Fax(310) 412-1705
Sole ProprietorYes
Enumeration DateSeptember 28, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1316039324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 29936
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
101 N LA BREA AVE, Inglewood, CA 90301
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Gwendolyn A Kelly D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 3, 2016 through May 3, 2028.

Opt-Out Effective DateMay 3, 2016
Opt-Out In Effect ThroughMay 3, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GERALD GREGA DC
Chiropractor
101 N LA BREA AVE, #101
INGLEWOOD, CA 90301
Los Angeles County (310) 674-1565
MISS CATHARINE CHESNEY ERIKSON MA, MFTI
Counselor (Mental Health)
101 N LA BREA AVE, SUITE 301
INGLEWOOD, CA 90301
Los Angeles County (310) 412-0202
DR. BEHROOZ SAMOUHA DC
Chiropractor
101 N LA BREA AVE, 101
INGLEWOOD, CA 90301
Los Angeles County (310) 674-1565
MULTISERVICE FAMILY CENTER INC.
Case Management
101 N LA BREA AVE
INGLEWOOD, CA 90301
Los Angeles County (310) 412-0202
EUGENE CHRISTIAN EUGENE CHRISTIAN
Internal Medicine (Gastroenterology)
101 N LA BREA AVE, 306
INGLEWOOD, CA 90301
Los Angeles County (310) 671-3328
EVELYN S CLARK
Marriage & Family Therapist
101 N LA BREA AVE, SUITE301
INGLEWOOD, CA 90301
Los Angeles County (310) 412-0202
DARCY CARROLL
Marriage & Family Therapist
101 N LA BREA AVE, SUITE 301
INGLEWOOD, CA 90301
Los Angeles County (310) 412-0202
MULTISERVICE FAMILY CENTER, INC.
Clinic/Center (Community Health)
101 N LA BREA AVE, SUITE 301
INGLEWOOD, CA 90301
Los Angeles County (310) 412-0202

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gwendolyn Kelly's NPI number?

The NPI number for Gwendolyn Kelly is 1316039324. It was assigned to this individual provider in the NPPES registry on September 28, 2006.

Where is Gwendolyn Kelly located?

Gwendolyn Kelly practices at 101 N La Brea Ave Suite 506, Inglewood, CA 90301. The listed phone number is (310) 412-9291.

What is Gwendolyn Kelly's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Gwendolyn Kelly enrolled in Medicare?

No. Gwendolyn Kelly has opted out of Medicare through May 3, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Gwendolyn Kelly was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.