Individual provider Active NPI

Kelli Junker, DDS

  • General Practice Dentistry
  • Newport Beach, CA
National Provider Identifier
1003830464
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
51160 Issued in CA
Practice address
400 Newport Center Dr
Suite 708
Newport Beach, CA 92660-7601
Phone
(949) 640-2970
Fax
(949) 640-2838
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 51160 CA Primary

Addresses

Primary practice location

400 Newport Center Dr
Suite 708
Newport Beach, CA 92660-7601

Mailing address

400 Newport Center #708
Newport Beach, CA 92660-8604
Phone (949) 640-2970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
51160CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kelli Junker DDS Inc Past Accepting new patients
Kelli Junker DDS Inc General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296691200000",
    "number": "1003830464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER #708",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608604",
            "telephone_number": "949-640-2970",
            "fax_number": "949-640-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER DR",
            "address_2": "SUITE 708",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607601",
            "telephone_number": "949-640-2970",
            "fax_number": "949-640-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNKER",
        "first_name": "KELLI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.