Kenneth L. Stasun D.D.S. a Professional Corporateon

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

21516 Issued in CA

Legal business name

KENNETH L. STASUN D.D.S. A PROFESSIONAL CORPORATEON

Practice address

423 Johnston St
Half Moon Bay, CA 94019-1717

Phone

(650) 726-7523

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Louis Stasun, D.D.S.

Title

President Orthodontist

Phone

(650) 726-7523

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831214303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 JOHNSTON ST",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940191717",
            "telephone_number": "650-726-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 JOHNSTON ST",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940191717",
            "telephone_number": "650-726-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH L. STASUN D.D.S. A PROFESSIONAL CORPORATEON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STASUN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT ORTHODONTIST",
        "authorized_official_telephone_number": "650-726-7523",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "21516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Johnson, LAUREN JOHNSON
• Tara Maria Johnston, DDS
• Laura Jane Kauth, LMFT
• Russel Kayser, PSY.D.
• Torsten Chester Werner Keil-Long, ACSW, PPSC
• Amanda Kerseg, CMT
• Jane Leslie Kinsley, LMFT
• Michael Klass, MD
• Stephanie J Klee, FNP-BC
• Jeremiah Kloss, DC

• Orthodontics and Dentofacial Orthopedics Dentistry in Half Moon Bay, CA
• Providers in Half Moon Bay, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.