KERI KM DENTAL GROUP, A PROFESSIONAL GROUP (NPI# 1932553633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932553633 |
| Entity Type | Organization |
| Organization Name | KERI KM DENTAL GROUP, A PROFESSIONAL GROUP |
| Other Organization Name | THE SUPERDENTISTS |
| Practice Address |
9737 Aero Dr Ste 210 San Diego CA 92123-1859 |
| Practice Telephone | 6195858500 |
| Practice Fax Number | 6193629923 |
| Mailing Telephone | 6195858500 |
| Mailing Fax Number | 6193629923 |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-04-19 |
| Authorized Official Name | MRS. LAURA ELENA FLORES (MANAGER) |
| Authorized Official Telephone | 6198691149 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
42542 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| The Superdentists | Doing Business As Name - Organization |
| Street Address |
9737 AERO DR STE 210 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-1859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144549833 | Brittany Koncz | Dentist | 9737 Aero Dr Ste 210, San Diego, CA 92123 | 2010-05-20 |
| 1700388907 | Christina Kulyk | Dentist | 9737 Aero Dr Ste 210, San Diego, CA 92123-1854 | 2018-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437776812 | Andy L. Tieu Dds Inc. | Clinic/Center | 10549 Scripps Poway Pkwy Ste I, San Diego, CA 92131-3963 | 2020-07-01 |
| 1851925481 | Santos Salsbury Dental Corporation | Clinic/Center | 6699 Alvarado Rd Ste 2202, San Diego, CA 92120-5293 | 2020-02-22 |
| 1194365015 | Valadez Dental Corp | Clinic/Center | 2650 Camino Del Rio N Ste 102, San Diego, CA 92108-1630 | 2020-01-08 |
| 1619434065 | Marco Savittieri, Dds., Inc. | Clinic/Center | 12613 El Camino Real Unit A, San Diego, CA 92130-4077 | 2019-02-21 |
| 1760977516 | Jeremy Walker Dental Corporation | Clinic/Center | 3330 3rd Ave Ste 302, San Diego, CA 92103-5639 | 2018-06-25 |
| 1235629502 | Ricardo Peralta Dds Inc | Clinic/Center | 9855 Erma Rd Ste 103, San Diego, CA 92131-1007 | 2018-05-12 |
| 1326535576 | Ryan Wallrich Dmd, PC | Clinic/Center | 1310 Rosecrans St Ste B, San Diego, CA 92106-4609 | 2018-04-13 |
| 1356847438 | Arvinda Reddy Kunduru, Dds Inc. | Clinic/Center | 5440 Morehouse Dr Ste 1800, San Diego, CA 92121-6705 | 2018-04-05 |
| 1447767447 | Florabel F. Oliver-badillo Dmd, Inc. | Clinic/Center | 10717 Camino Ruiz Ste 122, San Diego, CA 92126-2362 | 2017-12-29 |
| 1073036539 | Balboa Family Dentistry | Clinic/Center | 3737 Moraga Ave Ste B307, San Diego, CA 92117-5360 | 2017-07-17 |
| Find all providers in SAN DIEGO | ||||
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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.