What is Kenneth Fedor's NPI number?

The NPI number assigned to this healthcare provider is 1700812393, enumerated as a individual on June 24, 2006.

Where is the provider located?

The provider is located at 3350 LA JOLLA VILLAGE DR SAN DIEGO, CA 92161 and the phone number is (858) 557-7525.

What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223G0001X and a focus in General Practice.

DR. KENNETH M FEDOR D.D.S. - NPI 1700812393

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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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