Active NPI
Janice Kaeley, DDS, MSD
- Periodontics
- San Ramon, CA
National Provider Identifier
1659616654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 57658
- Practice address
- 9301 Fircrest LN Ste 5
San Ramon, CA 94583-3960 - Phone
- (925) 860-7270
- NPI assigned
- Dec 1, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 12011365A | IN | |
| Periodontics | 1223P0300X | 57658 | CA | Primary |
Addresses
Primary practice location
9301 Fircrest LN Ste 5
San Ramon, CA 94583-3960
Mailing address
9301 Fircrest LN Ste 5
San Ramon, CA 94583-3960
Phone (925) 860-7270
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57658 | CA | MD | Periodontist |
| 12011365A | IN | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Janice Kaeley DDS, a Professional Dental Corporation | Periodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Periodontics
- San Ramon, CA
- NPI 1982067161
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516752000000",
"number": "1659616654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9301 FIRCREST LN STE 5",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945833960",
"telephone_number": "925-860-7270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9301 FIRCREST LN STE 5",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945833960",
"telephone_number": "925-860-7270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAELEY",
"first_name": "JANICE",
"credential": "DDS, MSD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-01",
"last_updated": "2018-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "IN",
"license": "12011365A",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "57658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.