Individual provider Active NPI

Jeffrey R. Kindseth, DDS

  • General Practice Dentistry
  • Dana Point, CA
National Provider Identifier
1043346125
Registry record updated Dec 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39168 Issued in CA
Practice address
24721 La PLZ
Dana Point, CA 92629-2509
Phone
(949) 661-2152
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2016

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 39168 CA Primary

Addresses

Primary practice location

24721 La PLZ
Dana Point, CA 92629-2509

Mailing address

24721 La PLZ
Dana Point, CA 92629-2509
Phone (949) 661-2152

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
39168CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480723200000",
    "number": "1043346125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24721 LA PLZ",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926292509",
            "telephone_number": "949-661-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24721 LA PLZ",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926292509",
            "telephone_number": "949-661-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDSETH",
        "first_name": "JEFFREY",
        "middle_name": "R.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2016-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dana Point, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2016; 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.