Individual provider Active NPI

Kamel Germanos, DDS

  • General Practice Dentistry
  • Corcoran, CA
National Provider Identifier
1891711438
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
40240 Issued in CA
Practice address
900 Quebec Ave
Corcoran, CA 93212-9715
Phone
(858) 688-3421
NPI assigned
Jul 15, 2006
Last updated
Mar 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 40240 CA Primary

Addresses

Primary practice location

900 Quebec Ave
Corcoran, CA 93212-9715

Mailing address

900 Quebec Ave
Corcoran, CA 93212-9715
Phone (858) 688-3421

Other identifiers 1

IdentifierTypeStateIssuer
043740226OtherCATAX ID

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
40240CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1891711438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 QUEBEC AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932129715",
            "telephone_number": "858-688-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 QUEBEC AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932129715",
            "telephone_number": "858-688-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERMANOS",
        "first_name": "KAMEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "043740226",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corcoran, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.