NPI
Homer Gary Ketcherside
NPI 1043570658
Read from the NPPES registry on October 24, 2026.
Facts
- Status
- Active
- Credential
- D.D.S.,M.S.
- Type
- Individual
- Enumeration date
- 2012-05-17
- Last updated
- 2013-07-22
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Specialties
Licenses
- License CA
- 28872
Location
- Practice location
- 720 Magnolia Ave, Suite A1
- City
- Corona CA
- Postal code
- 92879-3119
- Phone
- (951) 737-3800
- Fax
- (951) 737-3937
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Orthodontists in Corona, CA. 17 with this primary taxonomy in the public file.
Other NPIs in Corona, CA. 4,902 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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