Kenneth Richard Skyberg, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35168 Issued in CA

Practice address

424 Magnolia St
Gridley, CA 95948-2535

Phone

(530) 846-4815

Fax

(530) 846-0745

NPI assigned

Dec 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043371644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 MAGNOLIA ST",
            "city": "GRIDLEY",
            "state": "CA",
            "postal_code": "959482535",
            "telephone_number": "530-846-4815",
            "fax_number": "530-846-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 MAGNOLIA ST",
            "city": "GRIDLEY",
            "state": "CA",
            "postal_code": "959482535",
            "telephone_number": "530-846-4815",
            "fax_number": "530-846-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKYBERG",
        "first_name": "KENNETH",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surinderpal Singh Sarai, PHARMD
• Brenda Shawley, PTA
• Amandpreet Shokar
• Manjinder Singh
• Suzanne Taylor Singson, FNP
• Janet Lee Smith, LMFT
• Raveena Sohal
• Jose Solis, P.T.,D.P.T.
• Arica Elizabeth Souza
• Rachel Steinhart, MD

• General Practice Dentistry in Gridley, CA
• Providers in Gridley, CA by specialty
• General Practice Dentistry in California

• 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.

Verify at the official NPI Registry.