Organization Active NPI

Andrew S. Kiss, DDS, MD, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Tustin, CA
National Provider Identifier
1629700711
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ANDREW S. KISS, DDS, MD, INC.
Practice address
18102 Irvine Blvd Ste 201
Tustin, CA 92780-3424
Phone
(714) 767-6971
NPI assigned
Jun 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Authorized official

Name
Andrw Kiss, DDS, MD
Title
President
Phone
(714) 767-6971

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

18102 Irvine Blvd Ste 201
Tustin, CA 92780-3424

Mailing address

7886 Orchid Dr
Huntington Beach, CA 92648-5682

Other practice location 1

25460 Medical Center Dr Ste 201
Murrieta, CA 92562-5985
Phone (951) 698-4681

Other practice location 2

265 San Jacinto River Rd Ste 101
Lake Elsinore, CA 92530-4400
Phone (951) 471-3334

Other practice location 3

12009 Garfield Ave
South Gate, CA 90280-7822
Phone (562) 630-7777

National Provider Directory

National Provider Directory

Locations

265 San Jacinto River Rd
Ste 101
Lake Elsinore, CA 92530
Phone (951) 471-3334

25460 Medical Center Dr
Ste 201
Murrieta, CA 92562
Phone (951) 698-4681

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656288000000",
    "number": "1629700711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7886 ORCHID DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926485682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18102 IRVINE BLVD STE 201",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803424",
            "telephone_number": "714-767-6971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25460 Medical Center Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925625985",
            "country_code": "US",
            "telephone_number": "951-698-4681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "265 San Jacinto River Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lake Elsinore",
            "state": "CA",
            "postal_code": "925304400",
            "country_code": "US",
            "telephone_number": "951-471-3334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12009 Garfield Ave",
            "address_purpose": "LOCATION",
            "city": "South Gate",
            "state": "CA",
            "postal_code": "902807822",
            "country_code": "US",
            "telephone_number": "562-630-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANDREW S. KISS, DDS, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A",
        "authorized_official_last_name": "KISS",
        "authorized_official_first_name": "ANDRW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-767-6971",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.