Active NPI
Aiko Kondo, DMD
- Dentist
- Visalia, CA
National Provider Identifier
1821647785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 104395
- Practice address
- 828 S Mooney Blvd
Visalia, CA 93277-2212 - Phone
- (559) 802-4300
- NPI assigned
- Sep 4, 2019
- 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 | 104395 | CA | Primary |
Addresses
Primary practice location
828 S Mooney Blvd
Visalia, CA 93277-2212
Mailing address
1245 N Woodland St Apt 101
Visalia, CA 93291-4788
Phone (216) 218-7614
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230510000331 | CA | Order and Referring Only - Oral Surgery | 6608232038 |
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": "1567555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567555200000",
"number": "1821647785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1245 N WOODLAND ST APT 101",
"city": "VISALIA",
"state": "CA",
"postal_code": "932914788",
"telephone_number": "216-218-7614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "828 S MOONEY BLVD",
"city": "VISALIA",
"state": "CA",
"postal_code": "932772212",
"telephone_number": "559-802-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONDO",
"first_name": "AIKO",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-04",
"last_updated": "2019-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "104395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Visalia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.