Active NPI
Kenneth Kon Hsu, D.D.S.
- Prosthodontics
- San Lorenzo, CA
National Provider Identifier
1770593113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 40247
- Practice address
- 15845 Channel St
Suite a
San Lorenzo, CA 94580-1441 - Phone
- (510) 276-3711
- NPI assigned
- Aug 8, 2006
- 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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 40247 | CA | Primary |
Addresses
Primary practice location
15845 Channel St
Suite a
San Lorenzo, CA 94580-1441
Mailing address
15845 Channel St
Suite a
San Lorenzo, CA 94580-1441
Phone (510) 276-3711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40247 | CA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1770593113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15845 CHANNEL ST",
"address_2": "SUITE A",
"city": "SAN LORENZO",
"state": "CA",
"postal_code": "945801441",
"telephone_number": "510-276-3711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15845 CHANNEL ST",
"address_2": "SUITE A",
"city": "SAN LORENZO",
"state": "CA",
"postal_code": "945801441",
"telephone_number": "510-276-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HSU",
"first_name": "KENNETH",
"middle_name": "KON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "40247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Lorenzo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.