Daiki a. Otsuka, DDS, PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DAIKI A. OTSUKA, DDS, PA

Doing business as

Parkside Dental Associates

Practice address

1617 Parker Ave
Fort Lee, NJ 07024-6950

Phone

(201) 461-0130

Fax

(201) 461-8525

NPI assigned

May 7, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Elaine Sumire Otsuka, DMDNPI 1619194180

Title

President

Phone

(201) 461-0130

Specialties & licenses 1

Addresses

Other names 1

• Parkside Dental Associates Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elaine Sumire Otsuka, D.M.D.

  • General Practice Dentistry
  • Fort Lee, NJ
  • NPI 1619194180
  NPD (past) Authorized official

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083827257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 PARKER AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246950",
            "telephone_number": "201-461-0130",
            "fax_number": "201-461-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 PARKER AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246950",
            "telephone_number": "201-461-0130",
            "fax_number": "201-461-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAIKI A. OTSUKA, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OTSUKA",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "SUMIRE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-461-0130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkside Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.