Krystle Lynne Fenton

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

56161 Issued in CA

Practice address

7915 Laguna Blvd
Suite 150
Elk Grove, CA 95758-7923

Phone

(909) 648-9876

NPI assigned

Oct 9, 2007

Last updated

Oct 18, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1447448089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7915 LAGUNA BLVD",
            "address_2": "SUITE 150",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587923",
            "telephone_number": "909-648-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7915 LAGUNA BLVD",
            "address_2": "SUITE 150",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587923",
            "telephone_number": "909-648-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "KRYSTLE",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Feliciana III
• Alyssa Nicole Feliciano
• Alexa Felix
• Marissa Felix
• Timothy Fenner
• Faith Fermin-Hayes, DPT
• Angelica Grace Fernandez
• Armando Fernandez, MS, LEP
• Cadence Renee Fernandez
• Cristina Fernandez

• General Practice Dentistry in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.