Tomoko Wada, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

64110 Issued in CA

Practice address

925 W 34TH St Ste 127
Ostrow School of Dentistry of Usc
Los Angeles, CA 90089-0058

Phone

(213) 740-3410

Fax

(213) 740-3573

NPI assigned

Oct 6, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1003219064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 W 34TH ST STE 127",
            "address_2": "OSTROW SCHOOL OF DENTISTRY OF USC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890641",
            "telephone_number": "213-740-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 W 34TH ST STE 127",
            "address_2": "OSTROW SCHOOL OF DENTISTRY OF USC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890058",
            "telephone_number": "213-740-3410",
            "fax_number": "213-740-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADA",
        "first_name": "TOMOKO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-06",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64110",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60264061",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Stuart Wachtel, M.D.
• Steve Wachtenheim
• Kali Marie Wachter, CRNA
• Kelly Kalei Wachter, MFT
• Eleanor Wada
• Miranda Waddle, OTR/L
• Mariah Claire Wade-Hak, RDN
• La Keisha Wade-Malone
• Christopher Wade, MD
• Densil Wade Jr.

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.