Organization Active NPI

Nolan Y Maehara DDS Inc

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1104045467
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25589 Issued in CA
Legal business name
NOLAN Y MAEHARA DDS INC
Practice address
1127 Wilshire Blvd
Suite 1101
Los Angeles, CA 90017
Phone
(213) 481-3911
Fax
(213) 481-7097
NPI assigned
Apr 25, 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
Ms. Elaine Mimura
Title
Office Manager
Phone
(213) 481-3911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 25589 CA Primary

Addresses

Primary practice location

1127 Wilshire Blvd
Suite 1101
Los Angeles, CA 90017

Mailing address

1127 Wilshire Blvd
Suite 1101
Los Angeles, CA 90017
Phone (213) 481-3911

Other identifiers 1

IdentifierTypeStateIssuer
B2558901OtherCADENTI CAL

National Provider Directory

National Provider Directory

Locations

1127 Wilshire Blvd
Ste 1101
Los Angeles, CA 90017
Phone (213) 481-3911

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": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104045467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD",
            "address_2": "SUITE 1101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90017",
            "telephone_number": "213-481-3911",
            "fax_number": "213-481-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD",
            "address_2": "SUITE 1101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90017",
            "telephone_number": "213-481-3911",
            "fax_number": "213-481-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOLAN Y MAEHARA DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIMURA",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "213-481-3911",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI CAL",
            "identifier": "B2558901",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, 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.