Kenneth John Patterson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40049 Issued in CA

Practice address

5222 Balboa Ave.
72
San Diego, CA 92117

Phone

(858) 277-5141

Fax

(858) 277-4179

NPI assigned

May 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1760695845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5222 BALBOA AVE.",
            "address_2": "72",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92117",
            "telephone_number": "858-277-5141",
            "fax_number": "858-277-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5222 BALBOA AVE.",
            "address_2": "72",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92117",
            "telephone_number": "858-277-5141",
            "fax_number": "858-277-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "KENNETH",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jo Ellen Patterson, PH.D.
• Jonay Patterson
• Kaleah Patterson
• Kari An Patterson, PT, DPT
• Kate Patterson
• Kiara Patterson
• Laura Martha Patterson, B.S.
• Lauren Patterson, MOT, OTR/L
• Mary Elizabeth Patterson, M.D.
• Opal S Patterson, LVN

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.