Individual provider Active NPI

Brian Kiyoshi Hirayama, D.D.S.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1558537605
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
035199 Issued in CA
Practice address
8727 1/2 La Tijera Blvd
Los Angeles, CA 90045-3906
Phone
(310) 348-8000
Fax
(310) 348-8000
NPI assigned
May 7, 2008
Last updated
Mar 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 035199 CA Primary

Addresses

Primary practice location

8727 1/2 La Tijera Blvd
Los Angeles, CA 90045-3906

Mailing address

8727 1/2 La Tijera Blvd
Los Angeles, CA 90045-3906
Phone (310) 348-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151223001411 CA Order and Referring Only - DentistPractitioner - Dentist 5496056020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35199CAMDChiropractor
035199CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333065600000",
    "number": "1558537605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8727 1/2 LA TIJERA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453906",
            "telephone_number": "310-348-8000",
            "fax_number": "310-348-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8727 1/2 LA TIJERA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453906",
            "telephone_number": "310-348-8000",
            "fax_number": "310-348-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRAYAMA",
        "first_name": "BRIAN",
        "middle_name": "KIYOSHI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "035199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.