Ron Takahashi, DDS MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

39567 Issued in CA

Practice address

345 Estudillo Ave
Suite 100
San Leandro, CA 94577

Phone

(510) 483-5111

Fax

(510) 483-9793

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 9, 2018 through Apr 9, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Northern California Facial and Oral Surgery Centers

  • Dentist
  • San Leandro, CA
  • NPI 1780984252
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497824197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 ESTUDILLO AVE",
            "address_2": "SUITE 100",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94577",
            "telephone_number": "510-483-5111",
            "fax_number": "510-483-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 ESTUDILLO AVE",
            "address_2": "SUITE 100",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94577",
            "telephone_number": "510-483-5111",
            "fax_number": "510-483-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKAHASHI",
        "first_name": "RON",
        "name_prefix": "Dr.",
        "credential": "DDS MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "39567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin August Taft
• Emily Brooke Taggart
• Valerie Tai
• Tailored by Tami LLC
• George Yoichi Takahashi, D.D.S.
• Dara Lynn Takami
• Livneet Kaur Takhar, FNP
• Megan Talton
• Janelle L Tam, DMD
• Rebecca Tam

• Oral and Maxillofacial Surgery (Dentist) in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.