Active NPI
Kevin Scott Perry, DDS
- General Practice Dentistry
- Fresno, CA
National Provider Identifier
1265748941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 59566
- Practice address
- 6753 N Willow Ave
Fresno, CA 93710-5900 - Phone
- (559) 424-1088
- Fax
- (559) 314-6753
- NPI assigned
- Aug 19, 2010
- Sex
- Male
- 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 | 59566 | CA | Primary |
Addresses
Primary practice location
6753 N Willow Ave
Fresno, CA 93710-5900
Mailing address
6753 N Willow Ave
Fresno, CA 93710-5900
Phone (559) 424-1088
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 |
|---|---|---|---|
| 59566 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willow Dental Group | Past | Accepting new patients | |
| Willow Sleep Health Dental Group, SE Anderson, DDS Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Fresno, CA
- NPI 1043610165
-
- Dental Clinic/Center
- Fresno, CA
- NPI 1487233615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392768000000",
"number": "1265748941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6753 N WILLOW AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105900",
"telephone_number": "559-424-1088",
"fax_number": "559-314-6753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6753 N WILLOW AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105900",
"telephone_number": "559-424-1088",
"fax_number": "559-314-6753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRY",
"first_name": "KEVIN",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-19",
"last_updated": "2014-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "59566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.