Andrew Kunio Matsunaga, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28755 Issued in CA

Practice address

47 Duesenberg Dr #201
Thousand Oaks, CA 91362-3447

Phone

(805) 496-3121

Fax

(805) 496-8101

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083782130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 DUESENBERG DR #201",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913623447",
            "telephone_number": "805-496-3121",
            "fax_number": "805-496-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 DUESENBERG DR #201",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913623447",
            "telephone_number": "805-496-3121",
            "fax_number": "805-496-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUNAGA",
        "first_name": "ANDREW",
        "middle_name": "KUNIO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "B2875501",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rami Matar, MD
• Alex Matthew Matavosian, PA-C
• Tania Mateos
• Lisa Lee Mathis, MD
• John D Matrisciano, MD
• Meredith G Matzkin, M.D.
• Tom Maxim
• Juan Maya
• Grace T Mayemura
• Natalie Peyton Mayer, NONE

• General Practice Dentistry in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.