Individual provider Active NPI

Kevin Swartzberg, D.D.S.

  • General Practice Dentistry
  • Lemon Grove, CA
National Provider Identifier
1700129608
Registry record updated Mar 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39895 Issued in CA
Practice address
3050 Main St
Lemon Grove, CA 91945-2426
Phone
(619) 463-9931
Fax
(619) 463-9317
NPI assigned
Mar 29, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 39895 CA Primary

Addresses

Primary practice location

3050 Main St
Lemon Grove, CA 91945-2426

Mailing address

3050 Main St
Lemon Grove, CA 91945-2426
Phone (619) 463-9931

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160502000629 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042519712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39895CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Kevin Swartzberg Dental Corporation General Practice Past Accepting new patients

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": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1700129608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 MAIN ST",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919452426",
            "telephone_number": "619-463-9931",
            "fax_number": "619-463-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 MAIN ST",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919452426",
            "telephone_number": "619-463-9931",
            "fax_number": "619-463-9317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWARTZBERG",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-29",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemon Grove, CA

Sources for this page

Verify at the official NPI Registry.