Terry Pratt D.D.S., Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D20716 Issued in CA

Legal business name

TERRY PRATT D.D.S., INC.

Practice address

2217 Central Ave
Alameda, CA 94501-4410

Phone

(510) 522-7010

Fax

(510) 522-2654

NPI assigned

Apr 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Terry Pratt, D.D.S.

Title

Owner Doctor

Phone

(510) 522-7010

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760607196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 CENTRAL AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014410",
            "telephone_number": "510-522-7010",
            "fax_number": "510-522-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 CENTRAL AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014410",
            "telephone_number": "510-522-7010",
            "fax_number": "510-522-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY PRATT D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "TERRY",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "510-522-7010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "D20716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "D20716",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Alameda, CA
• Providers in Alameda, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.