Individual provider Active NPI

Russel Kyle Catterlin Jr., DDS

  • General Practice Dentistry
  • Monterey, CA
National Provider Identifier
1912978248
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33071 Issued in CA
Practice address
423 Corporal Evans Road
Presidio of Monterey Dental Clinic
Monterey, CA 93944
Phone
(831) 242-5612
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 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 33071 CA Primary

Addresses

Primary practice location

423 Corporal Evans Road
Presidio of Monterey Dental Clinic
Monterey, CA 93944

Mailing address

423 Corporal Evans Road
Presidio of Monterey Dental Clinic
Monterey, CA 93944-0000
Phone (831) 242-5612

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
33071CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1912978248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 CORPORAL EVANS ROAD",
            "address_2": "PRESIDIO OF MONTEREY DENTAL CLINIC",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939440000",
            "telephone_number": "831-242-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 CORPORAL EVANS ROAD",
            "address_2": "PRESIDIO OF MONTEREY DENTAL CLINIC",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "93944",
            "telephone_number": "831-242-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATTERLIN",
        "first_name": "RUSSEL",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.