Active NPI
Kimberly Jeanbe Butler, DDS
- Dentist
- Oakland, CA
National Provider Identifier
1225485402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64928
- Practice address
- 2838 Summit St
Oakland, CA 94609-3605 - Phone
- (510) 465-2838
- NPI assigned
- May 18, 2016
- Last updated
- May 18, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 64928 | CA | Primary |
Addresses
Primary practice location
2838 Summit St
Oakland, CA 94609-3605
Mailing address
2838 Summit St
Oakland, CA 94609-3605
Phone (510) 465-2838
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
| License | State | Type | Specialty |
|---|---|---|---|
| 64928 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakland Eco Dental | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Oakland, CA
- NPI 1396121828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463529600000",
"number": "1225485402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2838 SUMMIT ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093605",
"telephone_number": "510-465-2838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2838 SUMMIT ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093605",
"telephone_number": "510-465-2838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "KIMBERLY",
"middle_name": "JEANBE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-18",
"last_updated": "2016-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.