Active NPI
Yasuko Musashi, DDS
- General Practice Dentistry
- Fortson, GA
National Provider Identifier
1043425218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN013386
- Practice address
- 94 MC Crary Road
Fortson, GA 31803 - Phone
- (706) 987-8216
- Fax
- (706) 987-8220
- NPI assigned
- May 11, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN013386 | GA | Primary |
Addresses
Primary practice location
94 MC Crary Road
Fortson, GA 31803
Mailing address
1315 Delauney Ave
Suite 201
Columbus, GA 31901-2367
Phone (706) 322-9599
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DN013386 | Other | GA | GA LIC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160324001363 | GA | Order and Referring Only - Dentist | 5799082343 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN013386 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329696000000",
"number": "1043425218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 DELAUNEY AVE",
"address_2": "SUITE 201",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319012367",
"telephone_number": "706-322-9599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94 MC CRARY ROAD",
"city": "FORTSON",
"state": "GA",
"postal_code": "31803",
"telephone_number": "706-987-8216",
"fax_number": "706-987-8220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSASHI",
"first_name": "YASUKO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-11",
"last_updated": "2012-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN013386",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA LIC",
"identifier": "DN013386",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fortson, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.