J. Jay Uemura, D.D.S. a Dental Corporation

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

J. JAY UEMURA, D.D.S. A DENTAL CORPORATION

Doing business as

Innovative Periodontics and Dental Implants

Practice address

1416 Townview LN
Santa Rosa, CA 95405-7538

Phone

(707) 525-0555

Fax

(707) 525-0665

NPI assigned

Jun 10, 2020

Last updated

Jun 10, 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

Ms. Kathryn Uemura

Title

Cfo

Phone

(707) 479-7981

Specialties & licenses 1

Addresses

Other names 1

• Innovative Periodontics and Dental Implants Doing business as

Locations

Practitioners 2

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.

• Raime Shah, DDS, MS

  • Periodontics
  • Santa Rosa, CA
  • NPI 1518568138
  NPD
• Jay Uemura, D.D.S.

  • Periodontics
  • Santa Rosa, CA
  • NPI 1801958558
  NPD

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1154946622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 TOWNVIEW LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057538",
            "telephone_number": "707-525-0555",
            "fax_number": "707-525-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 TOWNVIEW LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057538",
            "telephone_number": "707-525-0555",
            "fax_number": "707-525-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. JAY UEMURA, D.D.S. A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "UEMURA",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "707-479-7981",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Periodontics and Dental Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Marie Ivaldi, CCC-SLP
• Rustem Ixanov, MS,PT
• Urvashi Iyer, DO
• J & L Millier Associates Inc. (At Your Service Nursing and Home Care)
• J Michael Harmon OD an Optometric Corporation (Sonoma Eyeworks)
• J&J Assisted Living, LLC
• Humaira Jabeen
• Anne Elizabeth Jackson, PH.D.
• Colleen C Jackson
• Erin Dickenson Jackson, LMFT

• Periodontics in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.