California Kidds Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

59512 Issued in CA

Legal business name

CALIFORNIA KIDDS PEDIATRIC DENTISTRY

Practice address

7525 N. Cedar Ave
#105
Fresno, CA 93720

Phone

(559) 439-6600

Fax

(559) 439-5400

NPI assigned

Jun 23, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeffrey B Evans, DDS

Title

Owner/Partner

Phone

(559) 439-6600

Specialties & licenses 2

Addresses

Other names 1

• Jeffrey Evans DDS & Jeffrey Kunkel DDS Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1003102443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 N. CEDAR AVE",
            "address_2": "#105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-439-6600",
            "fax_number": "559-439-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 N. CEDAR AVE",
            "address_2": "#105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-439-6600",
            "fax_number": "559-439-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA KIDDS PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "559-439-6600",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "59512",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "60083",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffrey Evans DDS & Jeffrey Kunkel DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.