Sean K Kutlay, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

63976 Issued in CA

Practice address

11628 Santa Monica Blvd
Los Angeles, CA 90025-2900

Phone

(310) 207-1060

NPI assigned

Oct 10, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• David a Tanner DDS Inc

  • General Practice Dentistry
  • Newhall, CA
  • NPI 1508234766
  NPD (past)

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440892800000",
    "number": "1225432875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11865 ROCHESTER AVE",
            "address_2": "UNIT 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11628 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252900",
            "telephone_number": "310-207-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTLAY",
        "first_name": "SEAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-10",
        "last_updated": "2015-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liza Kustantin
• Yulia Kustova, P.A.
• Jehuda David Kusuma
• Sydney Kusumoputro, MD
• Ruvy Rose Dayrit Kutilek, NP
• Sarah Jane Cella Kutrumbos, LMFT
• Rehema Said Kutua, MD
• Cagla Nur Kutukcu, MD
• Katherine Margaret Kutzer, MD
• Lisa Marie Kutzing, RN, IBCLC

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, 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 Aug 30, 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.