Individual provider Active NPI

Stephen Kane, DDS

  • Dentist
  • Berkeley, CA
National Provider Identifier
1821236787
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22234 Issued in CA
Practice address
856 Contra Costa Ave
Berkeley, CA 94707-1920
Phone
(510) 501-9501
NPI assigned
Jan 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22234 CA Primary

Addresses

Primary practice location

856 Contra Costa Ave
Berkeley, CA 94707-1920

Mailing address

856 Contra Costa Ave
Berkeley, CA 94707-1920
Phone (510) 501-9501

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
I20151029000279 CA Order and Referring Only - DentistPractitioner - Dentist 7113236365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1821236787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 CONTRA COSTA AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947071920",
            "telephone_number": "510-501-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 CONTRA COSTA AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947071920",
            "telephone_number": "510-501-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "22234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.