Peter T Kimball, D.M.D., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

40084 Issued in CA

Practice address

30190 Town Center Drive
Suite a
Laguna Niguel, CA 92677

Phone

(949) 363-3350

Fax

(949) 363-3351

NPI assigned

Jan 28, 2008

Sex

Male

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

Credentials

Master of Science

State licenses

Practice roles

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.

• Travis Kinser DDS MSD Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Laguna Niguel, CA
  • NPI 1104699487
  NPD (past)

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1487831871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30131 TOWN CENTER DR",
            "address_2": "SUITE 196",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772034",
            "telephone_number": "949-363-3350",
            "fax_number": "949-363-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30190 TOWN CENTER DRIVE",
            "address_2": "SUITE A",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "92677",
            "telephone_number": "949-363-3350",
            "fax_number": "949-363-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "PETER",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-28",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "40084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Yeon Su Kim, D.D.S
• Richard Kim, RN
• Ryan Kim
• Sarah Chan Yae Kim, MD
• Wesley Y Kim
• Kimberly V. Fogarty, Licensed Marriage & Family Therapy, PC (Innerself TeleTherapy)
• Kimberly Ward DDS, Inc.
• Sherry Marie King-Rockman, MFCC
• Monica Kinneberg, CMT
• Travis Wayne Kinser, DDS

• Orthodontics and Dentofacial Orthopedics Dentistry in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.