Individual provider Active NPI

Steven Bruce Kaminsky, DMD

  • Periodontics
  • Simi Valley, CA
National Provider Identifier
1972547446
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
32100 Issued in CA
Practice address
2796 Sycamore Dr
Ste 202
Simi Valley, CA 93065-1546
Phone
(805) 584-6225
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 32100 CA Primary

Addresses

Primary practice location

2796 Sycamore Dr
Ste 202
Simi Valley, CA 93065-1546

Mailing address

2796 Sycamore Dr
Ste 202
Simi Valley, CA 93065-1546
Phone (805) 584-6225

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
I20160323002694 CA Order and Referring Only - DentistPractitioner - Dentist 6406153113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32100CAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven Kaminsky DMD & Natasha Yashar DDS Periodontics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1972547446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2796 SYCAMORE DR",
            "address_2": "STE 202",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651546",
            "telephone_number": "805-584-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2796 SYCAMORE DR",
            "address_2": "STE 202",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651546",
            "telephone_number": "805-584-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMINSKY",
        "first_name": "STEVEN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "32100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.