Individual provider Active NPI

Kimberly Hiroshige Okumura, DDS

  • Dentist
  • Huntington Beach, CA
National Provider Identifier
1598830283
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39008 Issued in CA
Practice address
18700 Main Street
Suite 211
Huntington Beach, CA 92648
Phone
(714) 847-2507
Fax
(714) 842-7327
NPI assigned
Nov 21, 2006
Sex
Female
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
Dentist 122300000X 39008 CA Primary

Addresses

Primary practice location

18700 Main Street
Suite 211
Huntington Beach, CA 92648

Mailing address

18700 Main Street
Suite 211
Huntington Beach, CA 92648
Phone (714) 847-2507

Other names 1

  • Dr. Kimberly Hiroshige Former name

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
I20170113000459 CA Practitioner - Oral Surgery 3476835133 Practice locations: Huntington Beach, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39008CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598830283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18700 MAIN STREET",
            "address_2": "SUITE 211",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92648",
            "telephone_number": "714-847-2507",
            "fax_number": "714-842-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 MAIN STREET",
            "address_2": "SUITE 211",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92648",
            "telephone_number": "714-847-2507",
            "fax_number": "714-842-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIROSHIGE OKUMURA",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "39008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HIROSHIGE",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.