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DR. JACOB DEAN KELLY D.D.S.
NPI 1457769457
Dentist - General Practice in Roseville, CA

Active since July 23, 2014
2360 PROFESSIONAL DR STE 100, ROSEVILLE, CA 95661(916) 782-9479(916) 782-9479 Get Directions Write a Review

NPPES record last updated: July 1, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 1, 2021, Aug 17, 2018 (2 updates tracked since 2018).

About Dr. Jacob Dean Kelly D.d.s. NPPES

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

DR. JACOB DEAN KELLY D.D.S. (NPI 1457769457) is an individual general practice provider in Roseville, California, licensed in California (63699) and active in the NPI registry since July 2014.

NPPES Registry Identity

NPI1457769457
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. JACOB DEAN KELLYCredential: D.D.S.
Location Address2360 PROFESSIONAL DR STE 100Roseville, CA 95661-7782
Mailing Address2360 Professional Dr Ste 100Roseville, CA 95661-7782 · (916) 782-9479 · Fax (916) 782-9479
Phone(916) 782-9479
Fax(916) 782-9479
Sole ProprietorNo
Enumeration DateJuly 23, 2014
Last NPPES UpdateJuly 1, 20212 updates tracked since enumeration
NPPES CertifiedJuly 1, 2021
✔ NPI 1457769457 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 · 63699
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.
2360 PROFESSIONAL DR STE 100, Roseville, CA 95661
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Other Providers at the Same Location NPPES

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

JACOB D KELLY DDS, INC.
Clinic/Center (Dental)
2360 PROFESSIONAL DR STE 100
ROSEVILLE, CA 95661
Placer County (916) 782-9479

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 Jacob Kelly's NPI number?

The NPI number for Jacob Kelly is 1457769457. It was assigned to this individual provider in the NPPES registry on July 23, 2014.

Where is Jacob Kelly located?

Jacob Kelly practices at 2360 Professional Dr Ste 100, Roseville, CA 95661. The listed phone number is (916) 782-9479.

What is Jacob Kelly's specialty?

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

What insurance does Jacob Kelly accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Renaissance Dental list Jacob Kelly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacob Kelly was last updated on July 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.