Individual provider Active NPI

Leslie Hata, D.D.S.

  • General Practice Dentistry
  • Oakland, CA
National Provider Identifier
1164429338
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31795 Issued in CA
Practice address
5277 College Ave
Suite 106
Oakland, CA 94618-1437
Phone
(510) 653-7012
NPI assigned
Jul 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31795 CA Primary

Addresses

Primary practice location

5277 College Ave
Suite 106
Oakland, CA 94618-1437

Mailing address

5277 College Ave
Suite 106
Oakland, CA 94618-1437
Phone (510) 653-7012

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
31795CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1120348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1164429338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5277 COLLEGE AVE",
            "address_2": "SUITE 106",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181437",
            "telephone_number": "510-653-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5277 COLLEGE AVE",
            "address_2": "SUITE 106",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181437",
            "telephone_number": "510-653-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATA",
        "first_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-03",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.