Active NPI
Maimi Yamaguchi, D.D.S.
- Endodontics
- Vienna, VA
National Provider Identifier
1033664941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 0401415207
- Practice address
- 8310 Old Courthouse Rd
Vienna, VA 22182-3872 - Phone
- (704) 936-0770
- NPI assigned
- Aug 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | LL802 | MD | |
| Endodontics | 1223E0200X | 0401415207 | VA | Primary |
Addresses
Primary practice location
8310 Old Courthouse Rd
Vienna, VA 22182-3872
Mailing address
8310 Old Courthouse Rd
Vienna, VA 22182-3872
Phone (704) 936-0770
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 |
|---|---|---|---|
| LL802 | MD | MD | Endodontist |
| 0401415207 | VA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501718400000",
"number": "1033664941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8310 OLD COURTHOUSE RD",
"city": "VIENNA",
"state": "VA",
"postal_code": "221823872",
"telephone_number": "704-936-0770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8310 OLD COURTHOUSE RD",
"city": "VIENNA",
"state": "VA",
"postal_code": "221823872",
"telephone_number": "704-936-0770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAMAGUCHI",
"first_name": "MAIMI",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-20",
"last_updated": "2017-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MD",
"license": "LL802",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "VA",
"license": "0401415207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.