Kevin Kenji O'Brien

Primary specialty

DentistTaxonomy code 122300000X

License

106419 Issued in CA

Practice address

925 Secret River Dr
Sacramento, CA 95831-3465

Phone

(916) 391-9200

NPI assigned

Jul 1, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1992376842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 SECRET RIVER DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958313465",
            "telephone_number": "916-391-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 SECRET RIVER DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958313465",
            "telephone_number": "916-391-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5401 Arnold Ave # 88",
            "address_purpose": "LOCATION",
            "city": "McClellan",
            "state": "CA",
            "postal_code": "956521018",
            "country_code": "US",
            "telephone_number": "916-333-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "KEVIN",
        "middle_name": "KENJI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106419",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas C. O'Brien, PHARM.D.
• Emma McCarthy O'Brien, RN, IBCLC
• Emma Schaberg O'Brien, PT, DPT, CLT
• Jennifer Patrice O'Brien, PHARMD
• Kathryn O'Brien, FNP
• Madeleine O'Brien
• Michael O'Brien, DDS
• Pamela O'Brien
• Steven S O'Brien, MA
• Susan F O'Brien, PH D

• Dentist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.