Individual provider Active NPI

Alexis Linnebur Kindred, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Novato, CA
National Provider Identifier
1689103228
Registry record updated Sep 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS044535 Issued in PA
Practice address
1805 Novato Blvd Ste 1
Novato, CA 94947-2934
Phone
(415) 892-1190
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS044535 PA Primary

Addresses

Primary practice location

1805 Novato Blvd Ste 1
Novato, CA 94947-2934

Mailing address

1805 Novato Blvd Ste 1
Novato, CA 94947-2934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250130004145 PA Practitioner - Maxillofacial Surgery 8123364445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Midwestern University College of Dental Medicine, Downers Grove, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

841 Hospital Rd
Suite 3300
Indiana, PA 15701-3620
Phone (724) 357-7490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS044535PAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Ipg Oral Surgery LLP Oral and Maxillofacial Surgery CurrentSince Nov 16, 2024 Accepting new patients

Locations

841 Hospital Rd
Ste 3300
Indiana, PA 15701
Phone (724) 357-7490

640 Kolter Dr
Indiana, PA 15701
Phone (724) 357-7196

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.

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789257600000",
    "number": "1689103228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 NOVATO BLVD STE 1",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949472934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 NOVATO BLVD STE 1",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949472934",
            "telephone_number": "415-892-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINNEBUR KINDRED",
        "first_name": "ALEXIS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2026-09-13",
        "certification_date": "2026-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS044535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

Verify at the official NPI Registry.