Individual provider Active NPI

Jeffrey Kramer, DDS

  • General Practice Dentistry
  • Orange, CA
National Provider Identifier
1932447307
Registry record updated Apr 16, 2013
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62042 Issued in CA
Practice address
172 N Tustin St
Ste. 104
Orange, CA 92867-7780
Phone
(714) 538-1178
NPI assigned
Jan 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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 62042 CA Primary

Addresses

Primary practice location

172 N Tustin St
Ste. 104
Orange, CA 92867-7780

Mailing address

418 Enclave Cir
Apt 303
Costa Mesa, CA 92626-8182
Phone (661) 220-0679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20150814013990 CA Order and Referring Only - DentistPractitioner - Dentist 4385959642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1358553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1932447307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 ENCLAVE CIR",
            "address_2": "APT 303",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926268182",
            "telephone_number": "661-220-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 N TUSTIN ST",
            "address_2": "STE. 104",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928677780",
            "telephone_number": "714-538-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-19",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.