NPIMap

Organization Active NPI

Fred H. Matsumoto D.D.S., Inc.

  • General Practice Dentistry
  • Cerritos, CA
National Provider Identifier
1407063852
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19932 Issued in CA
Legal business name
FRED H. MATSUMOTO D.D.S., INC.
Practice address
11416 South St
Cerritos, CA 90703-6611
Phone
(562) 860-5597
Fax
(562) 809-1947
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Fred Hiroshi Matsumoto, D.D.S.NPI 1659479582
Title
President
Phone
(562) 860-5597

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 19932 CA Primary

Addresses

Primary practice location

11416 South St
Cerritos, CA 90703-6611

Mailing address

11416 South St
Cerritos, CA 90703-6611
Phone (562) 860-5597

National Provider Directory

National Provider Directory

Locations

11416 South St
Cerritos, CA 90703
Phone (562) 860-5597

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407063852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11416 SOUTH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036611",
            "telephone_number": "562-860-5597",
            "fax_number": "562-809-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11416 SOUTH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036611",
            "telephone_number": "562-860-5597",
            "fax_number": "562-809-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED H. MATSUMOTO D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATSUMOTO",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "HIROSHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-860-5597",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "19932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

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