Active NPI
Kazu Takaki
- Dentist
- Orange, CA
National Provider Identifier
1013057272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 21769
- Practice address
- 530 S Main St
Orange, CA 92868-4525 - Phone
- (714) 480-3000
- Fax
- (714) 571-3560
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 21769 | CA | Primary |
Addresses
Primary practice location
530 S Main St
Orange, CA 92868-4525
Mailing address
3116 W 179TH St
Torrance, CA 90504-4010
Phone (714) 480-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D21769 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21769 | CA | MD | Occupational Therapist |
Interoperability endpoints
- ktakaki@direct.westerndental.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382054400000",
"number": "1013057272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3116 W 179TH ST",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905044010",
"telephone_number": "714-480-3000",
"fax_number": "714-571-3560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 S MAIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684525",
"telephone_number": "714-480-3000",
"fax_number": "714-571-3560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAKAKI",
"first_name": "KAZU",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2013-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "21769",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D21769",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.