Active NPI
Kevin Brent Dorsey, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Huntington Park, CA
National Provider Identifier
1376556597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 37976
- Practice address
- 3512 E Florence Ave
Huntington Park, CA 90255-5900 - Phone
- (323) 589-6765
- Fax
- (323) 589-4154
- NPI assigned
- Aug 15, 2006
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 37976 | CA | Primary |
Addresses
Primary practice location
3512 E Florence Ave
Huntington Park, CA 90255-5900
Mailing address
3512 E. Florence Ave.
Huntington Park, CA 90255
Phone (310) 378-6249
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 4, 2022 through Oct 4, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37976 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kevin B. Dorsey DDS Inc., a Professional Corporation | Past | Accepting new patients | |
| Dr, Anthony Torres and Dr. Kevin Dorsey | Oral and Maxillofacial Surgery | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Oral and Maxillofacial Pathology Dentistry
- Huntington Park, CA
- NPI 1154820686
-
- Oral and Maxillofacial Surgery (Dentist)
- Huntington Park, CA
- NPI 1235514530
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1376556597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3512 E. FLORENCE AVE.",
"city": "HUNTINGTON PARK",
"state": "CA",
"postal_code": "90255",
"telephone_number": "310-378-6249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3512 E FLORENCE AVE",
"city": "HUNTINGTON PARK",
"state": "CA",
"postal_code": "902555900",
"telephone_number": "323-589-6765",
"fax_number": "323-589-4154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORSEY",
"first_name": "KEVIN",
"middle_name": "BRENT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CA",
"license": "37976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.