Kerrie Elise Cunningham, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DDS104748 Issued in CA

Practice address

721 W Huntington Dr Ste B
Arcadia, CA 91007-6734

Phone

(626) 574-1766

NPI assigned

Aug 14, 2014

Last updated

Feb 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hambik Oktanyan Dental Corporation

  dba Santa Anita Dental Group

  • General Practice Dentistry
  • Arcadia, CA
  • NPI 1588799126
  NPD (past)

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1639578826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S TAFT HILL RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805214240",
            "telephone_number": "970-482-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W HUNTINGTON DR STE B",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910076734",
            "telephone_number": "626-574-1766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 S Taft Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805214240",
            "country_code": "US",
            "telephone_number": "970-482-6034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "KERRIE",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202337",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS104748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Arcadia, CA
• Providers in Arcadia, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.