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CRYSTAL KELSO DMD
NPI 1790138642
Dentist - General Practice in Bend, OR

Active since July 15, 2016PECOS Enrolled
62968 OB RILEY RD STE 12, BEND, OR 97703(855) 433-6825 Get Directions Write a Review

NPPES record last updated: September 27, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 27, 2024, Jul 15, 2016 (2 updates tracked since 2016).

About Crystal Kelso Dmd NPPES

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

CRYSTAL KELSO DMD (NPI 1790138642) is an individual general practice provider in Bend, Oregon, licensed in Oregon (D10498) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS and maintains a secondary practice location in Lincoln City.

NPPES Registry Identity

NPI1790138642
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameCRYSTAL KELSOCredential: DMD
Location Address62968 OB RILEY RD STE 12Bend, OR 97703-9443
Mailing Address6950 Ne Campus WayHillsboro, OR 97124-5611 · (503) 952-2125
Phone(855) 433-6825
Sole ProprietorNo
Enumeration DateJuly 15, 2016
Last NPPES UpdateSeptember 27, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 27, 2024
✔ NPI 1790138642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in OR · D10498
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.
62968 OB RILEY RD STE 12, Bend, OR 97703
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Secondary Practice Location 1

Location 11105 SE Jetty Ave, #BLincoln City, OR 97367-2632 · Phone (855) 433-6825

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crystal Kelso Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97703 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
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
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

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

DR. KAREN ZHOU DMD
Dentist
62968 OB RILEY RD STE 12
BEND, OR 97703
Deschutes County (855) 433-6825

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 Crystal Kelso's NPI number?

The NPI number for Crystal Kelso is 1790138642. It was assigned to this individual provider in the NPPES registry on July 15, 2016.

Where is Crystal Kelso located?

Crystal Kelso practices at 62968 Ob Riley Rd Ste 12, Bend, OR 97703. The listed phone number is (855) 433-6825.

What is Crystal Kelso's specialty?

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

Is Crystal Kelso enrolled in Medicare?

Yes. Crystal Kelso is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Crystal Kelso was last updated on September 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.