Active NPI
Darby London Kaiser, D.D.S.
- General Practice Dentistry
- Los Alamitos, CA
National Provider Identifier
1003973983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 41927
- Practice address
- 3612 Florista St
Los Alamitos, CA 90720-2423 - Phone
- (562) 598-4207
- Fax
- (562) 799-7037
- NPI assigned
- Jan 2, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 41927 | CA | Primary |
Addresses
Primary practice location
3612 Florista St
Los Alamitos, CA 90720-2423
Mailing address
3612 Florista St.
Los Alamitos, CA 90720
Phone (562) 598-4207
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150721000406 | CA | Order and Referring Only - Dentist | 7911210935 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41927 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Derick Pham DMD, Inc | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003973983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3612 FLORISTA ST.",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "90720",
"telephone_number": "562-598-4207",
"fax_number": "562-799-7037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3612 FLORISTA ST",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907202423",
"telephone_number": "562-598-4207",
"fax_number": "562-799-7037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAISER",
"first_name": "DARBY",
"middle_name": "LONDON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "41927",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Alamitos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.