Perry Richard Klokkevold, D.D.S., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

34623 Issued in CA

Practice address

23430 Hawthorne Blvd Ste 345
Torrance, CA 90505-4654

Phone

(310) 325-9969

NPI assigned

Apr 15, 2010

Sex

Male

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

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.

Opted out of Medicare

Yes, effective Jan 28, 2019 through Jan 28, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Rodriguez Dental Coporation

  • Prosthodontics
  • Torrance, CA
  • NPI 1649665985
  NPD (past)

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723334400000",
    "number": "1982920955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23430 HAWTHORNE BLVD STE 345",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054654",
            "telephone_number": "310-325-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23430 HAWTHORNE BLVD STE 345",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054654",
            "telephone_number": "310-325-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOKKEVOLD",
        "first_name": "PERRY",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2024-08-11",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "34623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley R. Klein, M.D.
• Jaclyn Rene Klekman, M.D.
• Charles Klepak, M.F.T.
• Lisa Mariko Klever, D.D.S.
• Rachel Lauren Kling, DPT
• Tori Keiko Klunk, M.S. SLP-CF
• Gwen Barbara Klyman-Friend, M.D.
• Kristen Knaus
• Lawrence Wayne Kneisley, M.D.
• Rachel Knopoff, M.D.

• Periodontics in Torrance, CA
• Providers in Torrance, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.