Healthcare Provider Details

I. General information

NPI: 1598267312
Provider Name (Legal Business Name): KJELD AAMODT DDS MS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2018
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 MARKET ST
SAN FRANCISCO CA
94105-3219
US

IV. Provider business mailing address

548 MARKET ST # 36184
SAN FRANCISCO CA
94104-5401
US

V. Phone/Fax

Practice location:
  • Phone: 831-238-7285
  • Fax:
Mailing address:
  • Phone: 831-238-7285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number64545
License Number StateCA

VIII. Authorized Official

Name: DR. KJELD A AAMODT
Title or Position: CHIEF MEDICAL OFFICER
Credential: DDS, MS
Phone: 831-238-7285