Provider Demographics
NPI:1407998198
Name:FERRARO, KENNETH N (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:N
Last Name:FERRARO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8327 DAVIS ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4998
Mailing Address - Country:US
Mailing Address - Phone:562-869-3037
Mailing Address - Fax:562-861-0943
Practice Address - Street 1:8327 DAVIS ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4998
Practice Address - Country:US
Practice Address - Phone:562-869-3037
Practice Address - Fax:562-861-0943
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice