KYLE PETTERSEN (NPI# 1275849986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275849986 |
| Entity Type | Individual |
| Full Name | KYLE PETTERSEN |
| Credential | DDS |
| Practice Address |
6735 Yucca St Unit 309 Los Angeles CA 90028-4659 |
| Practice Telephone | 5617153397 |
| Mailing Telephone | 5617153397 |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2013-10-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
0025983 | TX | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
59547 | CA | Dental Providers |
| Street Address |
6735 YUCCA ST UNIT 309 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90028-4659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154929859 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5500 W Sunset Blvd, Los Angeles, CA 90028 | 2020-10-14 |
| 1558993527 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5500 West Sunset Boulevard, Los Angeles, CA 90028 | 2020-02-07 |
| 1639715030 | Michelle Jennifer Martinez | Case Manager/Care Coordinator | 6838 Sunset Blvd., Hollywood, CA 90028 | 2019-11-20 |
| 1821562315 | Ronnie Jerome Jackson | Case Manager/Care Coordinator | Bhs Hollywood Recovery Center, 6838 Sunset Blvd, Hollywood, CA 90028 | 2019-01-17 |
| 1669961595 | Danielle Arce | Dietitian, Registered | 6721 De Longpre Ave, Los Angeles, CA 90028 | 2018-05-07 |
| 1982124772 | Yoon Kyung Lee | Pharmacist | 7201 Hollywood Blvd, Los Angeles, CA 90028 | 2017-06-22 |
| 1982133245 | Julia West | Pharmacist | 6201 Hollywood Blvd #126, Los Angeles, CA 90028 | 2017-06-08 |
| 1720527971 | Melissa Susac | Marriage & Family Therapist | 1540 Schrader Blvd, Garden Suite 12, Hollywood, CA 90028 | 2017-02-21 |
| 1023554284 | Arlene Aranda | Social Worker | 1873 Taft Ave, Los Angeles, CA 90028 | 2017-01-12 |
| 1912304775 | Damon Dodge | Marriage & Family Therapist | 7083 Hollywood Blvd, Los Angeles, CA 90028 | 2014-11-21 |
| Find all providers in zip 90028 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295349082 | Reza Mehr | Dentist | 900 W Temple St Apt 506, Los Angeles, CA 90012-4551 | 2020-08-31 |
| 1396355590 | Kamyar Moradian | Dentist | 9201 Venice Blvd, Los Angeles, CA 90034-3324 | 2020-08-04 |
| 1669096160 | Leora H Sheily Dds PC | Dentist | 4852 Melrose Ave, Los Angeles, CA 90029-3736 | 2020-06-01 |
| 1013539535 | Smit Dangaria Dds Phd Inc | Dentist | 1325 S Harvard Blvd, Los Angeles, CA 90006-4229 | 2020-05-07 |
| 1912530585 | Sara Bahri Sabokpey | Dentist | 2001 Stradella Rd, Los Angeles, CA 90077-2322 | 2020-02-21 |
| 1518504497 | Jonathan Dye | Dentist | 1626 Palo Alto St Apt 102, Los Angeles, CA 90026-5052 | 2019-12-10 |
| 1972147940 | Catherine Margary Cuaco Begazo | Dentist | 100 S Doheny Dr Apt 209, Los Angeles, CA 90048-2926 | 2019-11-03 |
| 1386285427 | Jefferson Dental Corporation | Dentist | 12013 Wilshire Blvd, Los Angeles, CA 90025-1201 | 2019-09-30 |
| 1043868698 | Semyon Segal | Dentist | 2815 W Sunset Blvd Ste 106, Los Angeles, CA 90026-2168 | 2019-08-27 |
| 1144875592 | Jay Singh | Dentist | 11346 Iowa Ave Apt 203, Los Angeles, CA 90025-6085 | 2019-08-02 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90028 |
Please comment or provide details below to improve the information on KYLE PETTERSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.