Individual provider Active NPI

David Tajima, D.D.S.

  • Prosthodontics
  • Camarillo, CA
National Provider Identifier
1467764696
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
59188 Issued in CA
Practice address
163 W Ventura Blvd
Suite C
Camarillo, CA 93010-8372
Phone
(805) 484-9300
NPI assigned
Jul 2, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 59188 CA Primary

Addresses

Primary practice location

163 W Ventura Blvd
Suite C
Camarillo, CA 93010-8372

Mailing address

163 W Ventura Blvd
Suite C
Camarillo, CA 93010-8372
Phone (805) 484-9300

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
59188CAMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1467764696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 W VENTURA BLVD",
            "address_2": "SUITE C",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930108372",
            "telephone_number": "805-484-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 W VENTURA BLVD",
            "address_2": "SUITE C",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930108372",
            "telephone_number": "805-484-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJIMA",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-02",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "59188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.