Christopher A Iwata, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25545 Issued in CA

Practice address

665 W 21St St
Apt 2
San Pedro, CA 90731-5550

Phone

(310) 832-1440

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609085133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 W 21ST ST",
            "address_2": "APT 2",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907315550",
            "telephone_number": "310-832-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 W 21ST ST",
            "address_2": "APT 2",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907315550",
            "telephone_number": "310-832-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWATA",
        "first_name": "CHRISTOPHER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25545",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "469",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006955",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT1354",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Michelle Iraci, NP-C
• Brittany Irvine
• Reese Prescott Isaacson
• Isc San Pedro Blasser Clinic
• Rick T Iwai, O.D.
• Gioia A Jacobson, MFTI
• Nicholas Stephen Jaksic, DDS
• James S. Brust, M.D., Inc.
• James T London M D a Professional Corporation
• Jane Davis Lisenced Clinical Social Worker Professional Psychotherapy

• General Practice Dentistry in San Pedro, CA
• Providers in San Pedro, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.