David a Tabata D D S Inc

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

26542 Issued in CA

Legal business name

DAVID A TABATA D D S INC

Practice address

1413 Foothill Blvd
Ste B
Laverne, CA 91750

Phone

(909) 596-1833

Fax

(909) 593-4722

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David A Tabata, DDSNPI 1831561836

Title

Owner

Phone

(909) 596-1831

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Tabata, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • La Verne, CA
  • NPI 1831561836

  Orthodontics and Dentofacial Orthopedics

  NPD (past) Authorized official

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332374400000",
    "number": "1285709824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 FOOTHILL BLVD",
            "city": "LAVERNE",
            "state": "CA",
            "postal_code": "91750",
            "telephone_number": "909-596-1831",
            "fax_number": "909-593-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 FOOTHILL BLVD",
            "address_2": "STE B",
            "city": "LAVERNE",
            "state": "CA",
            "postal_code": "91750",
            "telephone_number": "909-596-1833",
            "fax_number": "909-593-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A TABATA D D S INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2012-03-22",
        "status": "A",
        "authorized_official_last_name": "TABATA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-596-1831",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "26542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Laverne, CA
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.