Provider Demographics
NPI:1063574390
Name:HOSS, KAMI (DDS)
Entity type:Individual
Prefix:DR
First Name:KAMI
Middle Name:
Last Name:HOSS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2226 OTAY LAKES RD
Mailing Address - Street 2:STE. B
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-1000
Mailing Address - Country:US
Mailing Address - Phone:619-216-7846
Mailing Address - Fax:619-216-3676
Practice Address - Street 1:2226 OTAY LAKES RD
Practice Address - Street 2:STE. B
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-1000
Practice Address - Country:US
Practice Address - Phone:619-216-7846
Practice Address - Fax:619-216-3676
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA410161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA273076558OtherORTHODONTISTS
CA810569380OtherORTHODONTISTS