Emily Utagawa, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

43579 Issued in CA

Practice address

3456 Motor Ave Ste 105
Los Angeles, CA 90034-4737

Phone

(424) 258-6018

Fax

(424) 258-6306

NPI assigned

Feb 15, 2012

Last updated

Aug 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1336412741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3456 MOTOR AVE STE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900344737",
            "telephone_number": "424-258-6018",
            "fax_number": "424-258-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3456 MOTOR AVE STE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900344737",
            "telephone_number": "424-258-6018",
            "fax_number": "424-258-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTAGAWA",
        "first_name": "EMILY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-15",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DDS",
            "identifier": "43579",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTIST",
            "identifier": "13364127416",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.