Individual provider Active NPI

Robin Chikako Wakabayashi, DDS, MS

  • Periodontics
  • Los Angeles, CA
National Provider Identifier
1003925769
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
39573 Issued in CA
Practice address
420 E 3Rd Street
Ste 702
Los Angeles, CA 90013-1647
Phone
(213) 626-0561
Fax
(213) 626-0564
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 39573 CA Primary

Addresses

Primary practice location

420 E 3Rd Street
Ste 702
Los Angeles, CA 90013-1647

Mailing address

420 E 3Rd St Ste 702
Los Angeles, CA 90013-1647
Phone (213) 626-0561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160411002149 CA Order and Referring Only - DentistPractitioner - Dentist 2769780535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Wakamatsu & Wakamatsu DDS Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003925769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 3RD ST STE 702",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131647",
            "telephone_number": "213-626-0561",
            "fax_number": "213-626-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 3RD STREET",
            "address_2": "STE 702",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131647",
            "telephone_number": "213-626-0561",
            "fax_number": "213-626-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKABAYASHI",
        "first_name": "ROBIN",
        "middle_name": "CHIKAKO",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "39573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.