Kevin Barrett DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

27228 Issued in CA

Legal business name

KEVIN BARRETT DDS INC

Practice address

11980 San Vicente Blvd
Suite 802
Los Angeles, CA 90049-5012

Phone

(310) 820-4952

Fax

(310) 820-2296

NPI assigned

Jan 12, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Michael Kevin Barrett

Title

Doctor/Owner

Phone

(310) 820-4952

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1114463395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD",
            "address_2": "SUITE 802",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495012",
            "telephone_number": "310-820-4952",
            "fax_number": "310-820-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD",
            "address_2": "SUITE 802",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495012",
            "telephone_number": "310-820-4952",
            "fax_number": "310-820-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN BARRETT DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "310-820-4952",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "27228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kevin Im, M.D., a Medical Corp Defined.
• Kevin J. Chamas Inc.
• Kevin J. Pelton MD, Inc.

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.