Healthcare Provider Details

I. General information

NPI: 1841978970
Provider Name (Legal Business Name): KAIKO PERKINS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 EASTERN AVE STE 2
SACRAMENTO CA
95821-5445
US

IV. Provider business mailing address

3111 S ST # A-401
SACRAMENTO CA
95816-7061
US

V. Phone/Fax

Practice location:
  • Phone: 916-850-9999
  • Fax:
Mailing address:
  • Phone: 702-281-8135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDDS112806
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: