Organization Active NPI

David Kutner a Dental Corp

  • Dentist
  • San Bernardino, CA
National Provider Identifier
1992950281
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
27016 Issued in CA
Legal business name
DAVID KUTNER A DENTAL CORP
Practice address
695 W Highland Ave
San Bernardino, CA 92405-3812
Phone
(909) 881-2545
NPI assigned
Dec 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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

Authorized official

Name
Dr. David Kutner, DMD
Title
President
Phone
(626) 442-4582

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 27016 CA Primary

Addresses

Primary practice location

695 W Highland Ave
San Bernardino, CA 92405-3812

Mailing address

695 W Highland Ave
San Bernardino, CA 92405-3812
Phone (909) 881-2545

Other identifiers 1

IdentifierTypeStateIssuer
1174714547MedicaidCA

Other names 1

  • american family dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
American Family Dental4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228089600000",
    "number": "1992950281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053812",
            "telephone_number": "909-881-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053812",
            "telephone_number": "909-881-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID KUTNER A DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A",
        "authorized_official_last_name": "KUTNER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-442-4582",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "27016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174714547",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "american family dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.