Active NPI
Miranda Kore, DDS
- Dentist
- Palm Desert, CA
National Provider Identifier
1669995890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 101530
- Practice address
- 72415 Parkview Dr
Palm Desert, CA 92260-2779 - Phone
- (760) 568-5928
- NPI assigned
- Jul 19, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 101530 | CA | Primary |
Addresses
Primary practice location
72415 Parkview Dr
Palm Desert, CA 92260-2779
Mailing address
26423 Margarita LN
Loma Linda, CA 92354-6741
Phone (909) 363-5496
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170823003541 | CA | Order and Referring Only - Dentist | 8820360944 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101530 | CA | MD | Clinical Social Worker |
Interoperability endpoints
- mkore599442@direct.llu.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675382400000",
"number": "1669995890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26423 MARGARITA LN",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923546741",
"telephone_number": "909-363-5496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72415 PARKVIEW DR",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922602779",
"telephone_number": "760-568-5928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORE",
"first_name": "MIRANDA",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-19",
"last_updated": "2023-02-03",
"certification_date": "2023-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "101530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.