Individual provider Active NPI

Kenneth Earl Follmar II, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Gatos, CA
National Provider Identifier
1366530719
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
30785 Issued in CA
Practice address
14511 South Bascom Ave
Los Gatos, CA 95032
Phone
(408) 356-3146
Fax
(408) 356-0267
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 30785 CA Primary

Addresses

Primary practice location

14511 South Bascom Ave
Los Gatos, CA 95032

Mailing address

14511 South Bascom Ave
Los Gatos, CA 95032
Phone (408) 356-3146

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

LicenseStateTypeSpecialty
30785MAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1366530719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14511 SOUTH BASCOM AVE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-356-3146",
            "fax_number": "408-356-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14511 SOUTH BASCOM AVE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-356-3146",
            "fax_number": "408-356-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLLMAR",
        "first_name": "KENNETH",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "30785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.