Healthcare Provider Details
I. General information
NPI: 1649393604
Provider Name (Legal Business Name): NATHAN KAUFMAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 VENTURA AVE
ALBANY CA
94707-2122
US
IV. Provider business mailing address
901 VENTURA AVE
ALBANY CA
94707-2122
US
V. Phone/Fax
- Phone: 510-526-1757
- Fax: 510-526-3397
- Phone: 510-526-1757
- Fax: 510-526-3397
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 20885 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0700X |
| Taxonomy | Prosthodontics |
| License Number | 20885 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: