Kristy Chanelle Pleasant, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

105243 Issued in CA

Practice address

69160 Ramon Rd
Cathedral City, CA 92234-9140

Phone

(615) 674-9131

NPI assigned

Mar 6, 2019

Sex

Female

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1073653630
  Medicare reassignment NPD
• St. Johns Community Health

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1073363768
  NPD
• St. Johns Community Health

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1417469495
  NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1780376947
  NPD (past)

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1639637986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30620 PAULINE AVE",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922346266",
            "telephone_number": "615-674-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69160 RAMON RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922349140",
            "telephone_number": "615-674-9131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1262 Spring Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372095152",
            "country_code": "US",
            "telephone_number": "615-674-9131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLEASANT",
        "first_name": "KRISTY",
        "middle_name": "CHANELLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Desiree Porras, AMFT
• Present Senior Care
• Perri Sofian Putrasahan, DDS
• Edwin Ramirez

• Dentist in Cathedral City, CA
• Providers in Cathedral City, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.