Active NPI
Robert K Zimmer, D.D.S.
- Dentist
- Santa Ana, CA
National Provider Identifier
1306997002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30660
- Practice address
- 999 N Tustin Ave
Ste. 9
Santa Ana, CA 92705-3528 - Phone
- (714) 547-9194
- Fax
- (714) 565-2751
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- 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 | 30660 | CA | Primary |
Addresses
Primary practice location
999 N Tustin Ave
Ste. 9
Santa Ana, CA 92705-3528
Mailing address
27403 Ynez Rd Ste 105
Temecula, CA 92591-4614
Phone (951) 676-5607
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170921000338 | CA | Order and Referring Only - Other (Physician) | 2264706894 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30660 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508803200000",
"number": "1306997002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27403 YNEZ RD STE 105",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925914614",
"telephone_number": "951-676-5607",
"fax_number": "951-676-2566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "999 N TUSTIN AVE",
"address_2": "STE. 9",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927053528",
"telephone_number": "714-547-9194",
"fax_number": "714-565-2751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMER",
"first_name": "ROBERT",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2017-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "30660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.