Active NPI
Gerald Phillip Kaban, D.D.S.
- Dentist
- Vacaville, CA
National Provider Identifier
1366423162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 033940
- Practice address
- 3000 Alamo Dr
Suite 109
Vacaville, CA 95687-6350 - Phone
- (707) 689-5075
- NPI assigned
- Nov 9, 2005
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 033940 | CA | Primary |
Addresses
Primary practice location
3000 Alamo Dr
Suite 109
Vacaville, CA 95687-6350
Mailing address
3000 Alamo Dr
Suite 109
Vacaville, CA 95687
Phone (707) 689-5075
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033940 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424390400000",
"number": "1366423162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 ALAMO DR",
"address_2": "SUITE 109",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "95687",
"telephone_number": "707-689-5075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 ALAMO DR",
"address_2": "SUITE 109",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956876350",
"telephone_number": "707-689-5075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KABAN",
"first_name": "GERALD",
"middle_name": "PHILLIP",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-09",
"last_updated": "2015-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "033940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.