Individual provider Active NPI

Todd Hiroshi Yamada, D.D.S.

  • Periodontics
  • Los Angeles, CA
National Provider Identifier
1558587154
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
37521 Issued in CA
Practice address
11340 W Olympic Blvd
#360
Los Angeles, CA 90064-1608
Phone
(310) 473-2727
Fax
(310) 473-2141
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 37521 CA Primary

Addresses

Primary practice location

11340 W Olympic Blvd
#360
Los Angeles, CA 90064-1608

Mailing address

10515 Clarkson Rd
Los Angeles, CA 90064-4315
Phone (310) 558-4834

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
I20160811001584 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0941594071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558587154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10515 CLARKSON RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900644315",
            "telephone_number": "310-558-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 W OLYMPIC BLVD",
            "address_2": "#360",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641608",
            "telephone_number": "310-473-2727",
            "fax_number": "310-473-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMADA",
        "first_name": "TODD",
        "middle_name": "HIROSHI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "37521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.