DR. BRIAN KELLY HUTTO (NPI# 1568654986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568654986 |
| Entity Type | Individual |
| Full Name | DR. BRIAN KELLY HUTTO |
| Credential | DMD |
| Practice Address |
1213 Coffee Rd Suite D Modesto CA 95355-4229 |
| Practice Telephone | 2095225238 |
| Practice Fax Number | 2095224703 |
| Mailing Telephone | 2095225238 |
| Mailing Fax Number | 2095224703 |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2019-02-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
62106 | CA | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
12798 | MD | Dental Providers |
| Street Address |
1213 COFFEE RD SUITE D |
| City | MODESTO |
| State | CA |
| Zip Code | 95355-4229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023017225 | David Aaron Woodruff | Dentist | 1213 Coffee Rd, Suite K, Modesto, CA 95355-4229 | 2005-07-19 |
| 1548646839 | Edwin Y. Josephs Dds, Inc | Dentist | 1213 Coffee Rd, Ste. J, Modesto, CA 95355-4229 | 2015-08-10 |
| 1427391044 | Amanda Pearl Farley | Dentist | 1213 Coffee Rd, Suite C, Modesto, CA 95355-4229 | 2013-04-02 |
| 1366713018 | Betty Kilpatrick Hansen | Marriage & Family Therapist | 1213 Coffee Rd, Suite P, Modesto, CA 95355-4229 | 2012-01-25 |
| 1225320211 | Kelly Gaines | Family Medicine | 1213 Coffee Rd, Modesto, CA 95355-4229 | 2011-05-09 |
| 1629293618 | Jack Robert Holt | Dentist | 1213 Coffee Rd, Suite M, Modesto, CA 95355-4229 | 2007-04-16 |
| 1821110586 | Meridith Mccurdy-yeoman | Physician Assistant | 1213 Coffee Rd, Modesto, CA 95355-4229 | 2007-04-04 |
| 1598886178 | George J Di Cristina | Dentist | 1213 Coffee Rd, Suite J, Modesto, CA 95355-4229 | 2007-04-02 |
| 1073639043 | Sylvia Diane Victor | Marriage & Family Therapist | 1213 Coffee Rd, Suite P, Modesto, CA 95355-4229 | 2007-03-22 |
| 1588704951 | Lance Bautista | Dentist | 1213 Coffee Rd, Modesto, CA 95355-4229 | 2007-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
| 1205443116 | Altwal and Shelat Dds Inc | Dentist | 1317 Oakdale Road, Suite 310, Modesto, CA 95355 | 2020-09-24 |
| 1184255911 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 3401 Oakdale Road, Suite 505, Modesto, CA 95355 | 2020-01-30 |
| 1487133856 | Natalie Vargas | Behavior Technician | 1317 Oakdale Road Suite 610, Modesto, CA 95355 | 2018-08-07 |
| 1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
| 1043727514 | Emily Lauren Schaefer | Behavioral Analyst | 3425 Coffee Rd Ste C2, Modesto, CA 95355 | 2018-01-05 |
| 1376083691 | Hari Gnanasekeram, PC | Technician, Cardiology | 1303 Mable Avenu, Modesto, CA 95355 | 2017-03-06 |
| 1598139891 | Encompass Health Rehabilitation Hospital of Modesto, LLC | Rehabilitation Hospital | 1303 Mable Avenue, Modesto, CA 95355 | 2015-11-24 |
| 1013387844 | Diana Faith Kigenyi | Social Worker | 1225 Oakdale Road, Modesto, CA 95355 | 2015-10-06 |
| 1437530672 | Tzu Yi Wei | Acupuncturist | 2209 Coffee Road, Suite A, Modesto, CA 95355 | 2015-06-12 |
| Find all providers in zip 95355 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275957037 | Kevin Furmanek | Dentist | 3900 Sisk Rd Ste O, Modesto, CA 95356-3229 | 2014-02-13 |
| 1144339987 | Stanley Dale Baker | Dentist | 201 E Orangeburg Ave, Ste A, Modesto, CA 95350-5355 | 2006-08-29 |
| 1326468752 | Greater Modesto Dental Implant &oral Surgery Center | Dentist | 201 E Orangeburg Ave, Suite A, Modesto, CA 95350-5355 | 2014-04-24 |
| 1710134085 | Roland I. Young, Dds, Inc. | Dentist | 1316 Coffee Rd Ste E14, Modesto, CA 95355-3191 | 2008-08-19 |
| 1467593244 | Myron Roland Strasser Jr. | Dentist | 1429 College Ave, Suite J, Modesto, CA 95350-4057 | 2007-02-12 |
| 1346359171 | Michael Edward Cadra | Dentist | 201 E Orangeburg Ave, Ste A, Modesto, CA 95350-5355 | 2006-08-29 |
| 1609832427 | Roland I. Young | Dentist | 1316 Coffee Rd, Ste. E-14, Modesto, CA 95355-3191 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807979 | Ayed Hawatmeh Dds Inc | Dentist | 322 E Foothill Blvd, Pomona, CA 91767 | 2020-10-02 |
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1609493170 | Amir Haghshenas Dds | Dentist | 3880 S Bascom Ave Ste 213, San Jose, CA 95124-2675 | 2020-07-01 |
| 1316568900 | Beech & Reid Dental Partnership | Dentist | 464 E Calaveras Blvd Ste B3, Milpitas, CA 95035-5412 | 2020-05-05 |
| 1518506773 | Francisco Suarez, Dds Inc. | Dentist | 4606 Hollywood Blvd Ste A, Los Angeles, CA 90027-5462 | 2020-01-04 |
| 1831748839 | Slate Dental Corporation | Dentist | 6512 Lonetree Blvd Ste 100, Rocklin, CA 95765-5883 | 2019-09-11 |
| 1255980140 | Dr Maloux Macasaet Saguin Dental Corporation | Dentist | 9800 Topanga Canyon Blvd Ste J, Chatsworth, CA 91311-4075 | 2019-09-04 |
| 1891342267 | Amrollahie and Riman Dental Partnership | Dentist | 1442 Irvine Blvd Ste 225, Tustin, CA 92780-3846 | 2019-08-21 |
| 1548821572 | Hoang Dental Corporation | Dentist | 1356 W Valley Pkwy Ste J, Escondido, CA 92029-2138 | 2019-06-20 |
| 1073173860 | Omfs Care Center Partners | Dentist | 215 N Fresno St Ste 490, Fresno, CA 93701-0000 | 2019-06-14 |
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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.