Nishimori Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

NISHIMORI DENTAL CORPORATION

Practice address

200 S El Molino Ave Ste 1
Pasadena, CA 91101-2985

Phone

(626) 793-6947

NPI assigned

Mar 8, 2025

Last updated

Mar 8, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Derek Yutaka NishimoriNPI 1164807012

Title

Ceo

Phone

(626) 793-6947

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derek Yutaka Nishimori, D.D.S.

  • General Practice Dentistry
  • San Jose, CA
  • NPI 1164807012
  NPD Authorized official

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

{
    "created_epoch": "1741392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741392000000",
    "number": "1538968060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S EL MOLINO AVE STE 1",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012985",
            "telephone_number": "626-793-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S EL MOLINO AVE STE 1",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012985",
            "telephone_number": "626-793-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISHIMORI DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-08",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A",
        "authorized_official_last_name": "NISHIMORI",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "YUTAKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-793-6947",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Pasadena, CA
• Providers in Pasadena, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2025; 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.