Individual provider Active NPI

Kenneth Harold Webster, D.D.S.

  • General Practice Dentistry
  • Grass Valley, CA
National Provider Identifier
1245248152
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18218 Issued in CA
Practice address
280 Sierra College Drive
Suite 240
Grass Valley, CA 95945
Phone
(530) 477-5060
Fax
(530) 477-1066
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18218 CA
General Practice Dentistry 1223G0001X 18218 CA Primary

Addresses

Primary practice location

280 Sierra College Drive
Suite 240
Grass Valley, CA 95945

Mailing address

280 Sierra College Drive
Suite 240
Grass Valley, CA 95945
Phone (530) 477-5060

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
18218CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sean Michael Rockwell, DDS. a Professional Dental Corporation General Practice PastSince Oct 20, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1245248152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 SIERRA COLLEGE DRIVE",
            "address_2": "SUITE 240",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "95945",
            "telephone_number": "530-477-5060",
            "fax_number": "530-477-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SIERRA COLLEGE DRIVE",
            "address_2": "SUITE 240",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "95945",
            "telephone_number": "530-477-5060",
            "fax_number": "530-477-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "KENNETH",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "18218",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "18218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.