Ketcherside Dental Corporation
NPI 1629557517 · Orthodontics and Dentofacial Orthopedics Dentistry · Corona, CA
Ketcherside Dental Corporation is a Orthodontics and Dentofacial Orthopedics Dentistry organization in Corona, CA (NPI 1629557517).
Provider details
- NPI number
- 1629557517
- Entity type
- Organization
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Homer Ketcherside, President(909) 810-7167
- License
- 28872 (CA)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Brace Connection
- Doing business as
- Gary Ketcherside Orthodontics Inc
- Doing business as
- Packing House District Dental & Orthodontics
Additional practice locations (2)
- 1468 Industrial Park AveRedlands, CA 92374-2892Phone: (909) 793-1595Fax: (909) 307-2154
- 400 W Stuart Ave Ste 110Redlands, CA 92374-3129Phone: (909) 793-1595Fax: (909) 307-2154
Registry dates
- Enumerated
- 2018-08-10
- Last updated
- 2020-05-11
- Certified
- 2020-05-11
Frequently asked questions
- What is Ketcherside Dental Corporation's NPI number?
- Ketcherside Dental Corporation's National Provider Identifier (NPI) is 1629557517, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ketcherside Dental Corporation?
- Ketcherside Dental Corporation is classified in the NPPES registry as Orthodontics and Dentofacial Orthopedics Dentistry (Dental Providers).
- Where is Ketcherside Dental Corporation located?
- Ketcherside Dental Corporation's practice location on file with NPPES is 720 Magnolia Ave Ste A1, Corona, CA 92879-3119.
- What is Ketcherside Dental Corporation's phone number?
- The practice phone number listed in the NPPES registry for Ketcherside Dental Corporation is (951) 737-3800.
- Who is the authorized official for Ketcherside Dental Corporation?
- The authorized official listed on Ketcherside Dental Corporation's NPPES record is Homer Ketcherside, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ketcherside Dental Corporation's NPI active?
- Yes — Ketcherside Dental Corporation's NPI (1629557517) is active in the NPPES registry as of the last update on 2020-05-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.