Active NPI
Heidi Kohltfarber, DDS
- Dentist
- Durham, NC
National Provider Identifier
1780748558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 51273
- Practice address
- 239 South Bend Dr.
Durham, NC 27713 - Phone
- (909) 731-1176
- Fax
- (909) 558-4477
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 51273 | CA | Primary |
Addresses
Primary practice location
239 South Bend Dr.
Durham, NC 27713
Mailing address
Llusd Odrp Dept
11092 Anderson St.
Loma Linda, CA 92350-0001
Phone (909) 558-4602
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51273 | Other | CA | DENTAL LICENSE |
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 |
|---|---|---|---|
| 51273 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245628800000",
"number": "1780748558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "LLUSD ODRP DEPT",
"address_2": "11092 ANDERSON ST.",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923500001",
"telephone_number": "909-558-4602",
"fax_number": "909-558-4477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "239 SOUTH BEND DR.",
"city": "DURHAM",
"state": "NC",
"postal_code": "27713",
"telephone_number": "909-731-1176",
"fax_number": "909-558-4477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLTFARBER",
"first_name": "HEIDI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2009-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "51273",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "51273",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.