Individual provider Active NPI

Dean Shigeru Fujita, LDO

  • Optician
  • North Miami Beach, FL
National Provider Identifier
1356111306
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
5504 Issued in FL
Practice address
1425 NE 163Rd St
North Miami Beach, FL 33162-4624
Phone
(305) 949-5670
Fax
(305) 949-5675
NPI assigned
Jan 2, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 5504 FL Primary

Addresses

Primary practice location

1425 NE 163Rd St
North Miami Beach, FL 33162-4624

Mailing address

547 NE 130TH St
North Miami, FL 33161-7709
Phone (305) 709-0687

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

LicenseStateTypeSpecialty
5504FLMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1356111306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 NE 130TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331617709",
            "telephone_number": "305-709-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 NE 163RD ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624624",
            "telephone_number": "305-949-5670",
            "fax_number": "305-949-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUJITA",
        "first_name": "DEAN",
        "middle_name": "SHIGERU",
        "name_prefix": "Mr.",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "5504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.