DR. KELVIN SU (NPI# 1871599373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871599373 |
| Entity Type | Individual |
| Full Name | DR. KELVIN SU |
| Credential | D.D.S. |
| Practice Address |
440 N Mountain Ave Ste 116 Upland CA 91786-5183 |
| Practice Telephone | 9099853430 |
| Practice Fax Number | 9099851936 |
| Mailing Telephone | 9099853430 |
| Mailing Fax Number | 9099851936 |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2007-07-08 |
| NPI Deactivation Date | 03/21/2006 |
| NPI Reactivation Date | 2006-03-27 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 18936 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DENTICAL PROVIDER NUMBER | B18936-01 | 01 |
| CA | UNITED CONCORDIA PROVIDER | 967350 | 01 |
| Street Address |
440 N MOUNTAIN AVE STE 116 |
| City | UPLAND |
| State | CA |
| Zip Code | 91786-5183 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871999227 | Bradley Ching | Dentist | 440 N Mountain Ave, #116, Upland, CA 91786-5183 | 2014-11-12 |
| 1730589169 | Gillian Marie Williams | Registered Nurse | 440 N Mountain Ave, Suite 112, Upland, CA 91786-5183 | 2014-09-04 |
| 1427480524 | Samish Amit Patel | Internal Medicine | 440 N Mountain Ave, Suite 301, Upland, CA 91786-5183 | 2013-07-31 |
| 1508119157 | Stewart Wang Md Inc | Plastic Surgery | 440 N Mountain Ave, Suite 307, Upland, CA 91786-5183 | 2012-10-19 |
| 1164688875 | Mark Jeffrey Kunihira | Dentist | 440 N Mountain Ave, Suite 309, Upland, CA 91786-5183 | 2008-08-01 |
| 1366644916 | Negar Tabandeh | Dentist | 440 N Mountain Ave, Upland, CA 91786-5183 | 2007-06-05 |
| 1447380605 | Daniel Masato Kunihira | Dentist | 440 N Mountain Ave, Ste 309, Upland, CA 91786-5183 | 2007-03-06 |
| 1982747283 | Sheila Marshall | Marriage & Family Therapist | 440 N Mountain Ave, Ste 207, Upland, CA 91786-5183 | 2007-02-15 |
| 1255412326 | Katherine Zaharopoulos | Dentist | 440 N Mountain Ave, Suite #101, Upland, CA 91786-5183 | 2006-10-17 |
| 1245256049 | Allergy, Sinus & Asthma Consultants Inc. | Allergy & Immunology | 440 N Mountain Ave, Ste 301, Upland, CA 91786-5183 | 2006-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093254 | California Clinics, Inc | Physical Medicine & Rehabilitation | 818 N Mountain Ave Ste 102, Upland, CA 91786 | 2019-09-23 |
| 1699231621 | Lynn Keitz | Nurse Practitioner | 360 East 7th Street, Suite D, Upland, CA 91786 | 2019-02-14 |
| 1003386608 | Devin A Lockett | Counselor | 916 N, Mountain Ave. Suite D-1, Upland, CA 91786 | 2018-11-27 |
| 1265900096 | Right Ride | Driver | 1023 West Arrow Hwy Apt A, Upland, CA 91786 | 2018-11-09 |
| 1689142069 | Mike Sedat Safi | Driver | 1023 W Arrow Hwy, Apt A, Upland, CA 91786 | 2018-11-05 |
| 1902373640 | Barsoum Dental | Dentist | 258 E. 9th Street, Upland, CA 91786 | 2018-10-31 |
| 1346736600 | Jennifer Lynn Henshaw | Counselor | Rosewood Counseling Center, 288 W 9th Street, Upland, CA 91786 | 2018-07-10 |
| 1972099521 | Sadeg Aldolaim | Nurse Practitioner | 2086 W Arrow Route, Apt 824, Upland, CA 91786 | 2018-07-06 |
| 1831607332 | Sandra Sun | Pharmacist | 1445 E. Foothill Blvd., Upland, CA 91786 | 2018-01-18 |
| 1841713625 | Dynamic Performance Physical Therapy Inc | Clinic/Center | 2377 W. Foothill Blvd, Ste 20, Upland, CA 91786 | 2017-07-24 |
| Find all providers in zip 91786 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649817404 | Sung Ahn, Dds, Inc. | Dentist | 1490 E Foothill Blvd Ste B, Upland, CA 91786-4072 | 2019-11-28 |
| 1770053126 | G S Castillo Dental Corp | Dentist | 600 N Mountain Ave Ste C105, Upland, CA 91786-4359 | 2018-11-28 |
| 1255830865 | Rocio Fierros | Dentist | 2582 Thunder Mountain Rd, Upland, CA 91784-1189 | 2018-02-08 |
| 1730532946 | Michael Cervantes | Dentist | 2523 Mountain Ln, Upland, CA 91784-1075 | 2016-07-22 |
| 1851759484 | Daniel Wonil Hwang Dds, Inc. | Dentist | 2057 W. Foothill Blvd., Upland, CA 91786 | 2016-02-10 |
| 1760848931 | Michael K Okumoto | Dentist | 332 E 22nd St, Upland, CA 91784-8927 | 2016-01-04 |
| 1972991503 | Min Soo Han | Dentist | 2057 W Foothill Blvd, Upland, CA 91786-3548 | 2015-01-05 |
| 1477828432 | Carlos Y Leal Dds II Inc | Dentist | 659 E. 15 St Suite B, Upland, CA 91786 | 2012-03-09 |
| 1467725739 | Carlos Y Leal | Dentist | 659 E 15 St, Suite B, Upland, CA 91786 | 2012-02-17 |
| 1528347291 | Brian William Wegley | Dentist | 276 W 9th St, Upland, CA 91786-5949 | 2011-08-11 |
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| 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.