Active NPI
Lisa Itaya, D.D.S.
- General Practice Dentistry
- San Francisco, CA
National Provider Identifier
1538164314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 45710
- Practice address
- 155 5TH St
San Francisco, CA 94103-2919 - Phone
- (415) 749-3319
- NPI assigned
- Jun 17, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 45710 | CA | Primary |
Addresses
Primary practice location
155 5TH St
San Francisco, CA 94103-2919
Mailing address
PO Box 4303
Foster City, CA 94404-0303
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 |
|---|---|---|---|
| 45710 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402963200000",
"number": "1538164314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4303",
"city": "FOSTER CITY",
"state": "CA",
"postal_code": "944040303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 5TH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941032919",
"telephone_number": "415-749-3319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ITAYA",
"first_name": "LISA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-17",
"last_updated": "2014-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "45710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.