Kellen Mariko Tadano, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

46984 Issued in CA

Practice address

3144 El Camino Real Ste 102
Carlsbad, CA 92008-2194

Phone

(760) 720-2200

NPI assigned

Apr 25, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Kellen Tadano DDS PC

  • Dentist
  • Carlsbad, CA
  • NPI 1861405292
  NPD (past) Authorized official

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1962846568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3144 EL CAMINO REAL STE 102",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082194",
            "telephone_number": "760-720-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3144 EL CAMINO REAL STE 102",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082194",
            "telephone_number": "760-720-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADANO",
        "first_name": "KELLEN",
        "middle_name": "MARIKO",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-25",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Carlsbad, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; 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.