NPIMap

Organization Active NPI

Tanaka Dental Corporation

  • General Practice Dentistry
  • Chula Vista, CA
National Provider Identifier
1619069929
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39210 Issued in CA
Legal business name
TANAKA DENTAL CORPORATION
Practice address
212 Church Ave
Suite a
Chula Vista, CA 91910-2703
Phone
(619) 420-8696
Fax
(619) 420-6915
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Katherine M Tanaka, DDSNPI 1487787644
Title
Owner
Phone
(619) 420-8696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 39210 CA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 40575 CA

Addresses

Primary practice location

212 Church Ave
Suite a
Chula Vista, CA 91910-2703

Mailing address

212 Church Ave
Suite a
Chula Vista, CA 91910-2703
Phone (619) 420-8696

Other identifiers 1

IdentifierTypeStateIssuer
166470OtherCAUNITED CONDORDIA ID#

National Provider Directory

National Provider Directory

Locations

212 Church Ave
#A
Chula Vista, CA 91910
Phone (619) 420-8686

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619069929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 CHURCH AVE",
            "address_2": "SUITE A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102703",
            "telephone_number": "619-420-8696",
            "fax_number": "619-420-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 CHURCH AVE",
            "address_2": "SUITE A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102703",
            "telephone_number": "619-420-8696",
            "fax_number": "619-420-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANAKA DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TANAKA",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-420-8696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39210",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40575",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONDORDIA ID#",
            "identifier": "166470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • 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.