Individual provider Active NPI

Erika Kullberg, DMD

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1205130937
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1855532 Issued in MA
Practice address
2310 Craven St
San Diego, CA 92136-5596
Phone
(619) 556-8248
NPI assigned
Jan 10, 2011
Last updated
Jan 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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 DN1855532 MA Primary

Addresses

Primary practice location

2310 Craven St
San Diego, CA 92136-5596

Mailing address

1281 9TH Ave
Apt. 2513
San Diego, CA 92101-4633
Phone (619) 556-8248

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
DN1855532MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1205130937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 9TH AVE",
            "address_2": "APT. 2513",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014633",
            "telephone_number": "619-556-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 CRAVEN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921365596",
            "telephone_number": "619-556-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULLBERG",
        "first_name": "ERIKA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.