NPIMap

Organization Active NPI

Pediatric Dentistry of Los Altos

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Los Altos, CA
National Provider Identifier
1679797930
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
21718 Issued in CA
Legal business name
PEDIATRIC DENTISTRY OF LOS ALTOS
Practice address
731 Altos Oaks Dr
Los Altos, CA 94024-5402
Phone
(650) 948-6884
Fax
(650) 948-7244
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
James Kelly, DDS
Title
Dentist
Phone
(650) 948-6884

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 30395 CA
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 38101 CA
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 21718 CA Primary

Addresses

Primary practice location

731 Altos Oaks Dr
Los Altos, CA 94024-5402

Mailing address

731 Altos Oaks Dr
Los Altos, CA 94024-5402
Phone (650) 948-6884

Other names 1

  • pediatric dentistry of los altos Doing business as

National Provider Directory

National Provider Directory

Locations

731 Altos Oaks Dr
Los Altos, CA 94024
Phone (650) 948-6884

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1679797930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 ALTOS OAKS DR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245402",
            "telephone_number": "650-948-6884",
            "fax_number": "650-948-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 ALTOS OAKS DR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245402",
            "telephone_number": "650-948-6884",
            "fax_number": "650-948-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF LOS ALTOS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "650-948-6884",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "30395",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "38101",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "21718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "pediatric dentistry of los altos",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Altos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.