Individual provider Active NPI

Kimberlee Anne Michalek

  • General Practice Dentistry
  • Downey, CA
National Provider Identifier
1083260210
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS104180 Issued in CA
Practice address
8998 Apollo Way
Downey, CA 90242-4030
Phone
(562) 441-7212
NPI assigned
Aug 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS104180 CA
General Practice Dentistry 1223G0001X DDS104180 CA Primary

Addresses

Primary practice location

8998 Apollo Way
Downey, CA 90242-4030

Mailing address

7431 Edinger Ave Unit 312
Huntington Beach, CA 92647-7851

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
I20191015002623 CA Order and Referring Only - DentistPractitioner - Dentist 2668703182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS104180CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ariella Pessah Dental Corporation Dentist PastSince Aug 18, 2019 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": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1083260210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7431 EDINGER AVE UNIT 312",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8998 APOLLO WAY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902424030",
            "telephone_number": "562-441-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALEK",
        "first_name": "KIMBERLEE",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS104180",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS104180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.