Jacqueline M Kotula, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

59323 Issued in CA

Practice address

1648 Union St
San Francisco, CA 94123-4508

Phone

(415) 474-1555

NPI assigned

Jun 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Jacqueline Kotula, DDS, Inc.

  • Dental Clinic/Center
  • San Rafael, CA
  • NPI 1457008179
  NPD Authorized official
• Chase Kotula Dental Partnership

  • General Practice Dentistry
  • San Rafael, CA
  • NPI 1154669190
  NPD (past) Authorized official

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1659682888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 REDWOOD HWY STE A",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949035149",
            "telephone_number": "415-499-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 UNION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941234508",
            "telephone_number": "415-474-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTULA",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rishi Kothari, MD
• Marcelo T Kothenbeutel
• Shanna Lynne Kotin, MA, LMFT
• Anuradha Kottapalli, MD
• Kaitlyn Kottman, PA-C
• Abdul Kouanda, MD
• Aroma Koul
• Caitlin Maeve Koulakis, AGACNP-BC
• Yiannis Koullias, MD
• Indiana Koumrian

• Dentist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.