Individual provider Active NPI

Kenneth Boon Woon Khoo, D.D.S.

  • General Practice Dentistry
  • Orange, CA
National Provider Identifier
1346423357
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47271 Issued in CA
Practice address
2606 E Chapman Ave
Orange, CA 92869-3207
Phone
(714) 639-6181
Fax
(714) 639-6182
NPI assigned
Dec 12, 2007
Last updated
Dec 12, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 47271 CA Primary

Addresses

Primary practice location

2606 E Chapman Ave
Orange, CA 92869-3207

Mailing address

26061 Hinckley St
Loma Linda, CA 92354-3945
Phone (909) 796-8446

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
47271CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Artistic Smiles Dentistry 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.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1346423357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26061 HINCKLEY ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543945",
            "telephone_number": "909-796-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693207",
            "telephone_number": "714-639-6181",
            "fax_number": "714-639-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOO",
        "first_name": "KENNETH",
        "middle_name": "BOON WOON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.