Zsolt Horvath Kissevich, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

36317 Issued in CA

Practice address

444 N Tehama St Ste a
Willows, CA 95988-2546

Phone

(650) 206-0164

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: zkissevich@direct.westerndental.com

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1891837449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 N TEHAMA ST STE A",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882546",
            "telephone_number": "650-206-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N TEHAMA ST STE A",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882546",
            "telephone_number": "650-206-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSEVICH",
        "first_name": "ZSOLT",
        "middle_name": "HORVATH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D36317",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veronica Jimenez
• Joanne E Reid MD Inc
• John McDonald OD & Tim Robertson OD
• John Pierson DDS Inc
• Eloise Dickey Jones, MA
• Michell Danforth Knight, PA C
• Erika Elizabeth Krepelka, LCSW
• Lauren Nicole Kufer, MSOT OTR/L
• Justin Michael Lang, COTA
• Jenny Lynn Lazarus, MD

• General Practice Dentistry in Willows, CA
• Providers in Willows, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.