Individual provider Active NPI

Darby London Kaiser, D.D.S.

  • General Practice Dentistry
  • Los Alamitos, CA
National Provider Identifier
1003973983
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41927 Issued in CA
Practice address
3612 Florista St
Los Alamitos, CA 90720-2423
Phone
(562) 598-4207
Fax
(562) 799-7037
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150721000406 CA Order and Referring Only - DentistPractitioner - Dentist 7911210935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41927CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Derick Pham DMD, Inc General Practice PastSince Jan 10, 2021 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 and National Provider Directory roles.

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

Verify at the official NPI Registry.