Individual provider Active NPI

Nicole Elizabeth Kuske, DDS

  • Dentist
  • Huntington Beach, CA
National Provider Identifier
1588805535
Registry record updated Mar 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
57535 Issued in CA
Practice address
18341 Pammy LN
Huntington Beach, CA 92648-1433
Phone
(562) 964-0877
NPI assigned
Mar 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 57535 CA Primary

Addresses

Primary practice location

18341 Pammy LN
Huntington Beach, CA 92648-1433

Mailing address

18341 Pammy LN
Huntington Beach, CA 92648-1433
Phone (562) 964-0877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200204002527 CA Order and Referring Only - DentistPractitioner - Dentist 5193151462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57535CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237507200000",
    "number": "1588805535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18341 PAMMY LN",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481433",
            "telephone_number": "562-964-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18341 PAMMY LN",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481433",
            "telephone_number": "562-964-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSKE",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-20",
        "last_updated": "2009-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.