Active NPI
Kerry Elizabeth Andre, DDS
- General Practice Dentistry
- Pleasanton, CA
National Provider Identifier
1265704936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 43698
- Practice address
- 1436 Cedarwood LN Ste C
Pleasanton, CA 94566-6124 - Phone
- (925) 462-1990
- Fax
- (925) 462-7804
- NPI assigned
- Jan 27, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 43698 | CA | Primary |
Addresses
Primary practice location
1436 Cedarwood LN Ste C
Pleasanton, CA 94566-6124
Mailing address
1436 Cedarwood LN Ste C
Pleasanton, CA 94566-6124
Phone (925) 462-1990
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 |
|---|---|---|---|
| 43698 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Andre & Judson Dental Corporation | General Practice | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Pleasanton, CA
- NPI 1023312105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327622400000",
"number": "1265704936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1436 CEDARWOOD LN STE C",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945666124",
"telephone_number": "925-462-1990",
"fax_number": "925-462-7804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1436 CEDARWOOD LN STE C",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945666124",
"telephone_number": "925-462-1990",
"fax_number": "925-462-7804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRE",
"first_name": "KERRY",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-27",
"last_updated": "2012-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "43698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasanton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.