Active NPI
Dean Yoshito Mizuno, D.D.S.
- General Practice Dentistry
- Pasadena, CA
National Provider Identifier
1164520227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30253
- Practice address
- 87 E Green St
Suite 310
Pasadena, CA 91105-2070 - Phone
- (626) 796-4718
- Fax
- (626) 796-1394
- NPI assigned
- Sep 20, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30253 | CA | Primary |
Addresses
Primary practice location
87 E Green St
Suite 310
Pasadena, CA 91105-2070
Mailing address
87 E Green St
Suite 310
Pasadena, CA 91105-2070
Phone (626) 796-4718
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B30253-01 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30253 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238371200000",
"number": "1164520227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 E GREEN ST",
"address_2": "SUITE 310",
"city": "PASADENA",
"state": "CA",
"postal_code": "911052070",
"telephone_number": "626-796-4718",
"fax_number": "626-796-1394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 E GREEN ST",
"address_2": "SUITE 310",
"city": "PASADENA",
"state": "CA",
"postal_code": "911052070",
"telephone_number": "626-796-4718",
"fax_number": "626-796-1394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIZUNO",
"first_name": "DEAN",
"middle_name": "YOSHITO",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2009-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "30253",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "B30253-01",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.