NPIMap

Organization Active NPI

Kathleen a Siu Professional Corporation

  • Pediatric Dentistry
  • Valencia, CA
National Provider Identifier
1134518988
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
29472 Issued in CA
Legal business name
KATHLEEN A SIU PROFESSIONAL CORPORATION
Practice address
23838 Valencia Blvd
300
Valencia, CA 91355-5319
Phone
(661) 259-2960
Fax
(661) 259-5983
NPI assigned
Jan 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Authorized official

Name
Dr. Kathleen A Siu, D.M.D.NPI 1700961919
Title
Owner
Phone
(661) 259-2960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 29472 CA Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 28618 CA

Addresses

Primary practice location

23838 Valencia Blvd
300
Valencia, CA 91355-5319

Mailing address

23838 Valencia Blvd
300
Valencia, CA 91355-5319
Phone (661) 259-2960

National Provider Directory

National Provider Directory

Locations

23838 Valencia Blvd
Ste 300
Valencia, CA 91355
Phone (661) 215-6655

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1134518988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23838 VALENCIA BLVD",
            "address_2": "300",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913555319",
            "telephone_number": "661-259-2960",
            "fax_number": "661-259-5983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23838 VALENCIA BLVD",
            "address_2": "300",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913555319",
            "telephone_number": "661-259-2960",
            "fax_number": "661-259-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN A SIU PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "SIU",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-259-2960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "29472",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "28618",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; 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.