Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. KENNETH M FEDOR D.D.S.
NPI 1700812393
Dentist - General Practice in San Diego, CA

Q: What is Kenneth Fedor's NPI number?

The NPI number for Kenneth Fedor is 1700812393. It was assigned to this individual provider in the NPPES registry on June 24, 2006.

Q: What is Kenneth Fedor's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Fedor was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 36 days 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.

Active since June 24, 2006

3350 LA JOLLA VILLAGE DR, SAN DIEGO, CA 92161(858) 557-7525(858) 552-7507 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Kenneth M Fedor D.d.s. NPPES

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

DR. KENNETH M FEDOR D.D.S. (NPI 1700812393) is an individual general practice provider in San Diego, California, licensed in California (39400) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1700812393

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. KENNETH M FEDORCredential: D.D.S.

Location Address3350 LA JOLLA VILLAGE DRSan Diego, CA 92161-0002

Mailing Address1905 31st StSan Diego, CA 92102-1109 · (619) 236-1941

Phone(858) 557-7525

Fax(858) 552-7507

Sole ProprietorNo

Enumeration DateJune 24, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1700812393 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · 39400

Definition

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.

3350 LA JOLLA VILLAGE DR, San Diego, CA 92161

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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.

DR. JENNIFER ANNE FREIMUND M.D.

Internal Medicine (Geriatric Medicine)

3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161

San Diego County (858) 552-7475

MRS. LINDA REID HOLLAND PT

Physical Therapist

3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161

San Diego County (858) 552-7487

DR. JONATHAN M MEYER M.D.

Psychiatry & Neurology (Psychiatry)

3350 LA JOLLA VILLAGE DR, 116-A
SAN DIEGO, CA 92161

San Diego County (858) 642-3570

ANDREW BISMARK

Psychologist (Clinical)

3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161

San Diego County (858) 245-5825

LORNA FRANCES DOUCETTE

Pharmacist (Psychiatric)

3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161

San Diego County (828) 545-5072

MS. LISA ARAI PHARM.D.

Pharmacist (Psychiatric)

3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161

San Diego County (858) 552-8585

HAYLEY MARIE HOWELLS MPT

Physical Therapist

3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161

San Diego County (858) 642-3138

JOAN MARIE FITZGERALD RN, MSN, FNP

Nurse Practitioner (Family)

3350 LA JOLLA VILLAGE DR
SAN DIEGO, CA 92161

San Diego County (858) 552-8585

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 Kenneth Fedor's NPI number?

The NPI number for Kenneth Fedor is 1700812393. It was assigned to this individual provider in the NPPES registry on June 24, 2006.

Where is Kenneth Fedor located?

Kenneth Fedor practices at 3350 La Jolla Village Dr, San Diego, CA 92161. The listed phone number is (858) 557-7525.

What is Kenneth Fedor's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Kenneth Fedor was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 36 days 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.