Active NPI
Paul Kiyoshi Takemoto, D.D.S.
- Dentist
- Riverside, CA
National Provider Identifier
1225233042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 035455
- Practice address
- University of California Riverside
Riverside, CA 92521-0001 - Phone
- (951) 827-3039
- Fax
- (951) 827-3133
- NPI assigned
- Jun 20, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 035455 | CA | Primary |
Addresses
Primary practice location
University of California Riverside
Riverside, CA 92521-0001
Mailing address
36428 Mesa Edge Dr
Yucaipa, CA 92399-5828
Phone (909) 795-0094
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 |
|---|---|---|---|
| 035455 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201046400000",
"number": "1225233042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36428 MESA EDGE DR",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923995828",
"telephone_number": "909-795-0094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UNIVERSITY OF CALIFORNIA RIVERSIDE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925210001",
"telephone_number": "951-827-3039",
"fax_number": "951-827-3133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAKEMOTO",
"first_name": "PAUL",
"middle_name": "KIYOSHI",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-20",
"last_updated": "2008-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "035455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.