Lynn Watanabe DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

43408 Issued in CA

Legal business name

LYNN WATANABE DDS INC

Practice address

881 Alma Real Drive
Suite 222
Pacific Palisades, CA 90272

Phone

(310) 454-3111

Fax

(310) 459-5410

NPI assigned

Nov 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Lynn E Watanabe, DDSNPI 1053852590

Title

Dentist

Phone

(310) 454-3111

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.

• Lynn Watanabe, DDS

  • Dentist
  • Pacific Palisades, CA
  • NPI 1053852590
  NPD (past) Authorized official

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568538296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 ALMA REAL DRIVE",
            "address_2": "SUITE 222",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "90272",
            "telephone_number": "310-454-3111",
            "fax_number": "310-459-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 ALMA REAL DRIVE",
            "address_2": "SUITE 222",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "90272",
            "telephone_number": "310-454-3111",
            "fax_number": "310-459-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN WATANABE DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATANABE",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "310-454-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "43408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Pacific Palisades, CA
• Providers in Pacific Palisades, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.