Individual provider Active NPI

David H. Yoshimaru, D.D.S.

  • General Practice Dentistry
  • Santa Monica, CA
National Provider Identifier
1194732115
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38779 Issued in CA
Practice address
1304 15TH St
Suite 324
Santa Monica, CA 90404-1809
Phone
(310) 394-3631
Fax
(310) 393-4631
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 38779 CA Primary

Addresses

Primary practice location

1304 15TH St
Suite 324
Santa Monica, CA 90404-1809

Mailing address

1304 15TH St.
Suite 324
Santa Monica, CA 90404
Phone (310) 394-3631

Other identifiers 2

IdentifierTypeStateIssuer
38779OtherCALICENSE #
954373486OtherCATAX ID #

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
38779CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1194732115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 15TH ST.",
            "address_2": "SUITE 324",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-394-3631",
            "fax_number": "310-393-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 15TH ST",
            "address_2": "SUITE 324",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041809",
            "telephone_number": "310-394-3631",
            "fax_number": "310-393-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOSHIMARU",
        "first_name": "DAVID",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "38779",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "954373486",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.