Active NPI
John Michael Yamamoto, D.D.S., M.P.H.
- Public Health Dentistry
- Venice, CA
National Provider Identifier
1457485294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 40407
- Practice address
- 323 Lincoln Blvd
Venice, CA 90291-2842 - Phone
- (310) 392-4103
- NPI assigned
- Mar 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 40407 | CA | Primary |
Addresses
Primary practice location
323 Lincoln Blvd
Venice, CA 90291-2842
Mailing address
10951 National Blvd
#103
Los Angeles, CA 90064-4042
Phone (310) 474-8940
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40407 | CA | MD | Public Health Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| UCLA Venice Clinical | Past | Accepting new patients | |
| UCLA Venice Dental Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Venice, CA
- NPI 1932253184
-
- Dental Clinic/Center
- Venice, CA
- NPI 1255465902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457485294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10951 NATIONAL BLVD",
"address_2": "#103",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900644042",
"telephone_number": "310-474-8940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "323 LINCOLN BLVD",
"city": "VENICE",
"state": "CA",
"postal_code": "902912842",
"telephone_number": "310-392-4103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAMAMOTO",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.D.S., M.P.H.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "CA",
"license": "40407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venice, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.