# DR. KELLI HENDERSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1497961338
- **Gender:** F
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5743 | OK | Yes |
| 1223P0221X | Pediatric Dentistry | 60453 | KS | — |

## Other

- **Enumeration date:** 05/15/2007
- **Last updated:** 09/11/2025