Ktam DDS Dental Corp

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

57293 Issued in CA

Legal business name

KTAM DDS DENTAL CORP

Practice address

1505 Shepard Dr
#201
Santa Maria, CA 93454-7020

Phone

(949) 322-9778

NPI assigned

Aug 12, 2010

Last updated

Oct 8, 2010By 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

Keith Tam, DDSNPI 1710141783

Title

Ceo

Phone

(949) 322-9778

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keith H Tam, DDS

  • Pediatric Dentistry
  • Santa Maria, CA
  • NPI 1710141783
  NPD (past) Authorized official

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1609181858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 SHEPARD DR",
            "address_2": "#201",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547020",
            "telephone_number": "949-322-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 SHEPARD DR",
            "address_2": "#201",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547020",
            "telephone_number": "949-322-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KTAM DDS DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "TAM",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-322-9778",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "57293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Kristy
• Shelley Marie Krueger Rieke, M.S. CCC-SLP
• Meagan Kruger, BCABA
• Adrian Gustavo Krulewecki, DDS
• Sebastian Krzywinski
• Qing Kuang
• Simone Kucska
• Liliya Kulchitskaya
• Daniel Kuljian
• Bhanji D. Kundaria, M.D.

• Pediatric Dentistry in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.