Glenn M Fujinaka, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

25141 Issued in CA

Practice address

170 Santa Clara Ave
Suite 201
Oakland, CA 94610-1323

Phone

(510) 547-6611

Fax

(510) 547-6641

NPI assigned

Sep 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1407953151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 SANTA CLARA AVE",
            "address_2": "SUITE 201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101323",
            "telephone_number": "510-547-6611",
            "fax_number": "510-547-6641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 SANTA CLARA AVE",
            "address_2": "SUITE 201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101323",
            "telephone_number": "510-547-6611",
            "fax_number": "510-547-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUJINAKA",
        "first_name": "GLENN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "25141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerardo Moreno Fuentes
• Sabrina Ann Fuentes
• Saumaleato Fuimaono Jr.
• Victor Fujii, COTA
• Reri Fujimura
• Trevor Fujinaka, D.D.S., M.S.D.
• Luseane Fukofuka
• Anita Fukumoto, PHARMD
• Full Moon Acupuncture
• Full Spectrum Birthworkers LLC

• Periodontics in Oakland, CA
• Providers in Oakland, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.