Individual provider Active NPI

Lisa Akemi Mayeda, D.D.S.

  • Dentist
  • Fair Oaks, CA
National Provider Identifier
1083839823
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
42936 Issued in CA
Practice address
8920 Sunset Ave Ste a
Fair Oaks, CA 95628-6592
Phone
(916) 535-0061
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 42936 CA Primary

Addresses

Primary practice location

8920 Sunset Ave Ste a
Fair Oaks, CA 95628-6592

Mailing address

620 Keswick CT
Granite Bay, CA 95746-7156
Phone (916) 797-4875

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

LicenseStateTypeSpecialty
42936CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083839823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 KESWICK CT",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957467156",
            "telephone_number": "916-797-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 SUNSET AVE STE A",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956286592",
            "telephone_number": "916-535-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYEDA",
        "first_name": "LISA",
        "middle_name": "AKEMI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "42936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.