Active NPI
Kevin William Carrington, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Oakland, CA
National Provider Identifier
1689891004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 33732
- Practice address
- 1700 Broadway FL 4
Oakland, CA 94612-2116 - Phone
- (510) 893-3117
- Fax
- (510) 893-3101
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 33732 | CA | Primary |
Addresses
Primary practice location
1700 Broadway FL 4
Oakland, CA 94612-2116
Mailing address
1700 Broadway FL 4
Oakland, CA 94612-2116
Phone (510) 893-3117
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 |
|---|---|---|---|---|
| I20160328000709 | CA | Order and Referring Only - Oral Surgery | 7214234848 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33732 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689891004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 BROADWAY FL 4",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946122116",
"telephone_number": "510-893-3117",
"fax_number": "510-893-3101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 BROADWAY FL 4",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946122116",
"telephone_number": "510-893-3117",
"fax_number": "510-893-3101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRINGTON",
"first_name": "KEVIN",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "33732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.