Active NPI
Ae Ran Ku, DDS
- Dentist
- Ukiah, CA
National Provider Identifier
1346649951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 63936
- Practice address
- 1096 South Dora Street
Ukiah, CA 95482 - Phone
- (707) 462-5706
- NPI assigned
- Aug 19, 2014
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 63936 | CA | Primary |
Addresses
Primary practice location
1096 South Dora Street
Ukiah, CA 95482
Mailing address
1096 S Dora St
Ukiah, CA 95482-5737
Phone (707) 462-5706
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 63936 | Other | CA | DENTIST |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63936 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474416000000",
"number": "1346649951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1096 S DORA ST",
"city": "UKIAH",
"state": "CA",
"postal_code": "954825737",
"telephone_number": "707-462-5706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1096 SOUTH DORA STREET",
"city": "UKIAH",
"state": "CA",
"postal_code": "95482",
"telephone_number": "707-462-5706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KU",
"first_name": "AE RAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-19",
"last_updated": "2016-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "63936",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTIST",
"identifier": "63936",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.