DR. KIMBERLY JANE ANDERSON (NPI# 1710091889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710091889 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY JANE ANDERSON |
| Credential | D.D.S |
| Practice Address |
1621 Oak Ave Suite A Davis CA 95616-1000 |
| Practice Telephone | 5307588668 |
| Practice Fax Number | 5307581226 |
| Mailing Telephone | 5307588668 |
| Mailing Fax Number | 5307581226 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
42629 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124659594 | Kimberly G Anderson | Nurse Practitioner | 4089 42nd Sq, Vero Beach, FL 32967-1963 | 2020-02-03 |
| 1730724410 | Kimberly Susan Anderson | Specialist/Technologist | 708 W 4th St, Lewes, DE 19958-1284 | 2019-11-17 |
| 1740727312 | Kimberly Anderson | Licensed Practical Nurse | 102 Giminski Dr, Apartment 1, Syracuse, NY 13204-1304 | 2017-01-20 |
| 1467843292 | Kimberly Anderson | Registered Nurse | 8247 S 535 E, Sandy, UT 84070-0476 | 2015-02-16 |
| 1609279926 | Kimberly Anderson | Psychologist | 42 E Via Plaza Nueva, Santa Fe, NM 87507-8491 | 2014-10-01 |
| 1881003994 | Kimberly Dawn Anderson | Specialist/Technologist | 4280 S 246th Ave, Buckeye, AZ 85326-3351 | 2014-08-04 |
| 1295175537 | Kimberly Michelle Anderson | Case Manager/Care Coordinator | 1509 N Midwest Blvd Apt 8, Midwest City, OK 73110-3243 | 2013-07-01 |
| 1891062477 | Kimberly Michelle Anderson | Licensed Practical Nurse | 983 Ridgeway Ct Apt A, Lebanon, OH 45036-2562 | 2011-11-25 |
| 1417240003 | Kimberly Anderson | Community Health Worker | 900 North Courtenay Parkway, Suite 1, Merritt Island, FL 32953 | 2011-05-16 |
| 1487955068 | Kimberly Dawn Anderson | Pharmacy Technician | 13831 Chalco Valley Pkwy Ste 101, Omaha, NE 68138-6145 | 2010-11-12 |
| Street Address |
1621 OAK AVE SUITE A |
| City | DAVIS |
| State | CA |
| Zip Code | 95616-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134132590 | Michelle D. Miller | Dentist | 1621 Oak Ave, Suite A, Davis, CA 95616-1000 | 2006-08-15 |
| 1396086823 | Leslie Goyette Silver | Psychologist | 1621 Oak Ave, Davis, CA 95616-1000 | 2013-03-07 |
| 1811223126 | Florence Elmore | Psychologist | 1621 Oak Ave, Suite B, Davis, CA 95616-1000 | 2009-10-20 |
| 1780896233 | Ellen J. Pettit | Psychologist | 1621 Oak Ave, Suite B, Davis, CA 95616-1000 | 2007-05-05 |
| 1760602924 | Louise Phinizy Walker | Marriage & Family Therapist | 1621 Oak Ave, Suite B, Davis, CA 95616-1000 | 2007-04-27 |
| 1881738284 | Susan Rachel Brown | Psychologist | 1621 Oak Ave, Suite B, Davis, CA 95616-1000 | 2007-02-18 |
| 1205987567 | Susan Alice Cohen Byrne | Counselor | 1621 Oak Ave, Suite B, Davis, CA 95616-1000 | 2007-01-15 |
| 1679684575 | Martha Louise Gilmore | Psychologist | 1621 Oak Ave, Ste B, Davis, CA 95616-1000 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560871 | Anne-frances Ostrander | Physical Therapy Assistant | 397 La Rue Rd, Davis, CA 95616 | 2020-08-26 |
| 1487271458 | Alix Peloso Mahon | Behavior Technician | 1212 Alvarado Ave Apt 68, Davis, CA 95616 | 2020-06-25 |
| 1427671882 | Dhhs Ihs Cao Sacred Oaks Healing Center | Substance Abuse Rehabilitation Facility | 33100 County Road 31, Davis, CA 95616 | 2020-05-20 |
| 1871126961 | Linda Marie Adams | Dietitian, Registered | Uc Davis Occupational Health, One Shields Ave - Cowell Hall Room 35, Davis, CA 95616 | 2020-02-17 |
| 1851935217 | Timothy James Johnston | Orthotist | 635 Anderson Rd., Suite 18, Davis, CA 95616 | 2019-10-29 |
| 1386290716 | Dakota Cool | Specialist/Technologist | 750 Orchard Road, Davis, CA 95616 | 2019-08-12 |
| 1366908618 | Capitol Periodontal Group | Dentist | 750 F Street #5, Davis, CA 95616 | 2019-02-12 |
| 1831663434 | Elisha Niccole Cusumano | Specialist/Technologist | 264 Hickey Gym, 1 Shields Ave, Davis, CA 95616 | 2019-01-16 |
| 1609364991 | Aron Matthew Katz | Psychologist | One Shield Ave, Student Health & Wellness Center, Bhp, Davis, CA 95616 | 2018-04-23 |
| 1316463938 | Arielle Pinkston | Marriage & Family Therapist | 203 F St, Davis, CA 95616 | 2017-08-15 |
| Find all providers in zip 95616 | ||||
| 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 |
|---|---|---|---|---|
| 1578092854 | Shannon Chris Ram | Dentist | 1621 Oak Avenue, Suite A, Davis, CA 95616 | 2017-06-08 |
| 1104086875 | Samer Said Alassaad | Dentist | 635 Anderson Rd Ste 17, Davis, CA 95616 | 2008-06-16 |
| 1720255391 | Nikos M Menicou | Dentist | 1109 Kennedy Pl Ste 4, Davis, CA 95616-1271 | 2008-05-13 |
| 1164633509 | Wesley Shinichi Honbo | Dentist | 417 F St, Suite 1, Davis, CA 95616-4123 | 2007-05-25 |
| 1518087626 | R Bruce Thomas | Dentist | 1920 Sycamore Ln, Davis, CA 95616-0813 | 2007-03-30 |
| 1427191030 | Tracey Y Cook | Dentist | 227 C St, Davis, CA 95616-4521 | 2007-02-14 |
| 1275691255 | Clark J Gregor | Dentist | 1756 Picasso Ave, Suite C, Davis, CA 95618 | 2006-12-04 |
| 1134201783 | Angeline-diep Ngoc Lam | Dentist | 2839 Spafford St, Suite A, Davis, CA 95616-6801 | 2006-10-20 |
| 1356435325 | Howard Treman Shempp | Dentist | 1791 Oak Ave Ste D, Davis, CA 95616-1073 | 2006-10-03 |
| 1215020532 | Gregory D Wilcox | Dentist | 2079 Anderson Rd, Suite A, Davis, CA 95616-0672 | 2006-09-30 |
| Find all providers in DAVIS | ||||
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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.