Kyle Yamamoto, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

100953 Issued in CA

Practice address

22410 Hawthorne Blvd Ste 3
Torrance, CA 90505-2594

Phone

(310) 373-2238

NPI assigned

Apr 14, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 9, 2023 through Oct 9, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kyamamoto2524351@oc.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kyle Yamamoto, DDS, MD, Ms, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Torrance, CA
  • NPI 1962194084
  NPD Authorized official
• Lindon Ken Kawahara MD DMD

  • Ambulatory Surgical Clinic/Center
  • Torrance, CA
  • NPI 1104922772
  NPD (past)
• The Regents of the University of California

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Angeles, CA
  • NPI 1689692303
  NPD (past)

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1265886352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22410 HAWTHORNE BLVD STE 3",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905052594",
            "telephone_number": "310-373-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22410 HAWTHORNE BLVD STE 3",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905052594",
            "telephone_number": "310-373-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-14",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "100953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Toru Yamada, O.D.
• Eri Yamaguchi
• Rieko Yamaji, D.C,
• Anna Ly Yamamoto, PHARM D.
• Jon Yoichi Yamamoto, MD
• Richard Alan Yamamoto, M.D.
• Yun Yamanaka
• Anne Akemi Yamane, D.D.S.
• Jeffrey T Yamane, D.D.S.
• Roger Masashi Yamashiro, D.D.S.

• Oral and Maxillofacial Surgery (Dentist) in Torrance, CA
• Providers in Torrance, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.