Active NPI
Clark Izu, D.D.S.
- Endodontics
- Irvine, CA
National Provider Identifier
1114283033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 42920
- Practice address
- 20 Maryland
Irvine, CA 92606-1739 - Phone
- (562) 544-7033
- NPI assigned
- Apr 4, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 42920 | CA | Primary |
Addresses
Primary practice location
20 Maryland
Irvine, CA 92606-1739
Mailing address
20 Maryland
Irvine, CA 92606-1739
Phone (562) 544-7033
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42920 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clark a Izu DDS Inc | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Endodontics
- Irvine, CA
- NPI 1578577862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333497600000",
"number": "1114283033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 MARYLAND",
"city": "IRVINE",
"state": "CA",
"postal_code": "926061739",
"telephone_number": "562-544-7033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 MARYLAND",
"city": "IRVINE",
"state": "CA",
"postal_code": "926061739",
"telephone_number": "562-544-7033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IZU",
"first_name": "CLARK",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-04",
"last_updated": "2012-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "42920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.