Kenneth John Fischer, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

23603 Issued in CA

Practice address

1467 N Wanda Rd Ste 195
Villa Park, CA 92867-5344

Phone

(714) 633-1200

Fax

(714) 633-4740

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1881777969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7821 E PORTICO TER",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928676481",
            "telephone_number": "714-904-7264",
            "fax_number": "714-633-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1467 N WANDA RD STE 195",
            "city": "VILLA PARK",
            "state": "CA",
            "postal_code": "928675344",
            "telephone_number": "714-633-1200",
            "fax_number": "714-633-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "KENNETH",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "23603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Danh
• Arnold Philip Deutsch, M.D.
• Steven Downs, OD
• Harry Eisenbach
• Jennifer Emter
• Kristen Michele Fuller, M.D.
• James Patrick Furcolow, O.D.
• Kathleen Emilie Gallaher, M.D.
• Kathryn A. Gibbs, M.D.
• Golden Hands Orthopedic Group, Inc

• Orthodontics and Dentofacial Orthopedics Dentistry in Villa Park, CA
• Providers in Villa Park, 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 Jul 7, 2021; 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.