Individual provider Active NPI

Carter Satoru Yokoyama, D.D.S.

  • General Practice Dentistry
  • Kailua Kona, HI
National Provider Identifier
1609071687
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1745 Issued in HI
Practice address
75-5905 Walua Rd
Ste 7
Kailua Kona, HI 96740-5315
Phone
(808) 322-0101
Fax
(808) 326-9495
NPI assigned
Jun 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 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 1745 HI Primary

Addresses

Primary practice location

75-5905 Walua Rd
Ste 7
Kailua Kona, HI 96740-5315

Mailing address

75-5905 Walua Rd
Ste 7
Kailua Kona, HI 96740-5315
Phone (808) 322-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20150721003073 HI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6002129905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1745HIMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1609071687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5905 WALUA RD",
            "address_2": "STE 7",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967405315",
            "telephone_number": "808-322-0101",
            "fax_number": "808-326-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5905 WALUA RD",
            "address_2": "STE 7",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967405315",
            "telephone_number": "808-322-0101",
            "fax_number": "808-326-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOKOYAMA",
        "first_name": "CARTER",
        "middle_name": "SATORU",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "1745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

Verify at the official NPI Registry.