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DR. JEFFREY MICHAEL KOTSUBO D.D.S.
NPI 1184834442
Dentist - Endodontics in Santa Monica, CA

Active since May 23, 2007PECOS Enrolled
1304 15TH ST, SUITE #318, SANTA MONICA, CA 90404(310) 458-6677 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. Jeffrey Michael Kotsubo D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JEFFREY MICHAEL KOTSUBO D.D.S. (NPI 1184834442) is an individual endodontics provider in Santa Monica, California, licensed in California (38439) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184834442
Entity TypeIndividualMale
Primary Taxonomy1223E0200X
Provider Legal NameDR. JEFFREY MICHAEL KOTSUBOCredential: D.D.S.
Location Address1304 15TH ST, SUITE #318Santa Monica, CA 90404-1809
Mailing Address1304 15th St, Suite #318Santa Monica, CA 90404-1809 · (310) 458-6677
Phone(310) 458-6677
Sole ProprietorYes
Enumeration DateMay 23, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1184834442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers
Taxonomy Code1223E0200X
License✔ Licensed in CA · 38439
Definition
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
1304 15TH ST, Santa Monica, CA 90404
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jeffrey Michael Kotsubo D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90404 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDA BETH CHEN D.D.S.
Dentist (Prosthodontics)
1304 15TH ST, SUITE 311
SANTA MONICA, CA 90404
Los Angeles County (310) 656-8880
DR. ANA BRIGHTLEAF D.M.D.
Dentist (General Practice)
1304 15TH ST, SUITE 209
SANTA MONICA, CA 90404
Los Angeles County (310) 395-1810
DR. ASHKAN JALILI D.C.
Chiropractor
1304 15TH ST, 218
SANTA MONICA, CA 90404
Los Angeles County (310) 394-9436
DR. ANN ITA RYAN MD
Family Medicine
1304 15TH ST, SUITE 400
SANTA MONICA, CA 90404
Los Angeles County (310) 395-9442
DR. DAVID H. YOSHIMARU D.D.S.
Dentist (General Practice)
1304 15TH ST, SUITE 324
SANTA MONICA, CA 90404
Los Angeles County (310) 394-3631
SIDNEY N.M.N. BROWNSTEIN DDS
Dentist (General Practice)
1304 15TH ST, SUITE 301
SANTA MONICA, CA 90404
Los Angeles County (310) 450-3844
WESTSIDE GYNECOLOGY A MEDICAL CORPORATION
Obstetrics & Gynecology (Gynecology)
1304 15TH ST, #310
SANTA MONICA, CA 90404
Los Angeles County (310) 899-9799
KARI SAKURAI DDS
Dentist (General Practice)
1304 15TH ST, 403
SANTA MONICA, CA 90404
Los Angeles County (310) 458-6222

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeffrey Kotsubo's NPI number?

The NPI number for Jeffrey Kotsubo is 1184834442. It was assigned to this individual provider in the NPPES registry on May 23, 2007.

Where is Jeffrey Kotsubo located?

Jeffrey Kotsubo practices at 1304 15th St Suite #318, Santa Monica, CA 90404. The listed phone number is (310) 458-6677.

What is Jeffrey Kotsubo's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Jeffrey Kotsubo enrolled in Medicare?

Yes. Jeffrey Kotsubo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jeffrey Kotsubo was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.