NPIMap

Organization Active NPI

Walter Y. Kitajima, D.D.S., Inc.

  • General Practice Dentistry
  • Fremont, CA
National Provider Identifier
1093933608
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D 20213 Issued in CA
Legal business name
WALTER Y. KITAJIMA, D.D.S., INC.
Practice address
4549 Mattos Dr
Fremont, CA 94536-6736
Phone
(510) 792-6690
NPI assigned
Apr 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Walter KitajimaNPI 1184842692
Title
President
Phone
(510) 792-6690

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D 20213 CA Primary

Addresses

Primary practice location

4549 Mattos Dr
Fremont, CA 94536-6736

Mailing address

4549 Mattos Dr
Fremont, CA 94536-6736
Phone (510) 792-6690

National Provider Directory

National Provider Directory

Locations

4549 Mattos Dr
Fremont, CA 94536
Phone (510) 792-6690

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093933608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4549 MATTOS DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945366736",
            "telephone_number": "510-792-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4549 MATTOS DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945366736",
            "telephone_number": "510-792-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER Y. KITAJIMA, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KITAJIMA",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-792-6690"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "D 20213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • 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.