Individual provider Active NPI

Ronald Fujitaki, DDS

  • Periodontics
  • Fremont, CA
National Provider Identifier
1306129192
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
38284 Issued in CA
Practice address
3805 Beacon Ave
Ste C
Fremont, CA 94538-1464
Phone
(510) 796-8333
Fax
(510) 796-8492
NPI assigned
Sep 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 38284 CA Primary

Addresses

Primary practice location

3805 Beacon Ave
Ste C
Fremont, CA 94538-1464

Mailing address

3805 Beacon Ave
Ste C
Fremont, CA 94538-1464
Phone (510) 796-8333

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alan M. Lieberman, D.D.S., Apc Periodontics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1306129192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 BEACON AVE",
            "address_2": "STE C",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381464",
            "telephone_number": "510-796-8333",
            "fax_number": "510-796-8492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 BEACON AVE",
            "address_2": "STE C",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381464",
            "telephone_number": "510-796-8333",
            "fax_number": "510-796-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUJITAKI",
        "first_name": "RONALD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-28",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "38284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.