Individual provider Active NPI

Khrystal Audi, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • San Jose, CA
National Provider Identifier
1861028490
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
106155 Issued in CA
Practice address
1660 Willow St Ste 5
San Jose, CA 95125-5101
Phone
(408) 265-7530
NPI assigned
Mar 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 106155 CA Primary

Addresses

Primary practice location

1660 Willow St Ste 5
San Jose, CA 95125-5101

Mailing address

1660 Willow St Ste 5
San Jose, CA 95125-5101
Phone (408) 265-7530

Other practice location 1

856 N Hillview Dr
Milpitas, CA 95035-4544
Phone (408) 945-8646

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

LicenseStateTypeSpecialty
DDS106155CAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Kirk Yen, DDS, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1861028490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 WILLOW ST STE 5",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255101",
            "telephone_number": "408-265-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 WILLOW ST STE 5",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255101",
            "telephone_number": "408-265-7530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "856 N Hillview Dr",
            "address_purpose": "LOCATION",
            "city": "Milpitas",
            "state": "CA",
            "postal_code": "950354544",
            "country_code": "US",
            "telephone_number": "408-945-8646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUDI",
        "first_name": "KHRYSTAL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-15",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "106155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.