Kevin Tanner, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30850 Issued in CA

Practice address

8089 Madison Ave
Suite 2
Citrus Heights, CA 95610-7964

Phone

(916) 966-1473

Fax

(916) 966-0648

NPI assigned

Mar 5, 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 2

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kevin R Tanner, DDS a Dental Corporation

  • General Practice Dentistry
  • Citrus Heights, CA
  • NPI 1366122376
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1962531806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8089 MADISON AVE",
            "address_2": "SUITE 2",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956107964",
            "telephone_number": "916-966-1473",
            "fax_number": "916-966-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8089 MADISON AVE",
            "address_2": "SUITE 2",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956107964",
            "telephone_number": "916-966-1473",
            "fax_number": "916-966-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "331019637",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "526523",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genet Taddese, RN/BSN
• Haillie Adoley Tagoe
• Dixita Tailor
• Alexis R Taiviti
• Alan Kevin Tanner, D.D.S.
• Sarah Elizabeth Tanner
• Aymel John Tarrar, M.D.
• Araya Brie Tatsch
• Karen Taugher, O.D.
• Tavallaei DMD Corp

• General Practice Dentistry in Citrus Heights, CA
• Providers in Citrus Heights, 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 Oct 2, 2008; 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.