Coffee Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

COFFEE SURGERY CENTER, LLC

Doing business as

All Kids Dental Surgery Center

Practice address

2120 19TH St
Bakersfield, CA 93301-3709

Phone

(661) 213-4813

NPI assigned

May 10, 2011

Last updated

Oct 15, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Devin Larsen

Title

Ceo

Phone

(631) 445-0593

Specialties & licenses 1

Addresses

Other names 1

• All Kids Dental Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457643405. Details of each certification follow.

• CCN 05C0002140 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0002140

Legal name

ALL KIDS DENTAL SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 25, 2017

Last certification

Jun 7, 2018

Ownership / control type

Proprietary

Facility address

2120 19th St
Bakersfield, CA 93301

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792022400000",
    "number": "1457643405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 LAKESIDE BLVD STE 350",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773811216",
            "telephone_number": "713-489-2198",
            "fax_number": "713-489-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 19TH ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933013709",
            "telephone_number": "661-213-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-445-0593"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "All Kids Dental Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christine Marie Coca
• Jaclyn Cocagne
• Hilan J Cockrell
• Mitchell Cockrell
• Code Front Labs LLC
• James Leroy Coffey, MFC
• Mehgan Noel Coffey, NP
• Michelle Renee Coffman
• Rachel Lizbeth Coffman, AUD
• Sharron Ann Coffman

• Ambulatory Surgical Clinic/Center in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.