Individual provider Active NPI

Eddie Kuo, DDS

  • Dentist
  • Visalia, CA
National Provider Identifier
1851520738
Registry record updated Oct 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
58718 Issued in CA
Practice address
501 North Bridge Street
Visalia, CA 93291-5014
Phone
(559) 734-1939
Fax
(559) 734-4384
NPI assigned
Jul 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 987654321 CA
Dentist 122300000X 58718 CA Primary

Addresses

Primary practice location

501 North Bridge Street
Visalia, CA 93291-5014

Mailing address

314 North Main Street
Porterville, CA 93257-3730
Phone (559) 791-7000

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
I20141008002434 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6406076777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
987654321CAMDDentist
58718CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254787200000",
    "number": "1851520738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 NORTH MAIN STREET",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932573730",
            "telephone_number": "559-791-7000",
            "fax_number": "559-782-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 NORTH BRIDGE STREET",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915014",
            "telephone_number": "559-734-1939",
            "fax_number": "559-734-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUO",
        "first_name": "EDDIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-13",
        "last_updated": "2009-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "987654321",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.