Robert Mitsuo Nakamura, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20774 Issued in CA

Practice address

1206 S El Dorado St
Stockton, CA 95206-1343

Phone

(209) 462-1361

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• R Mitsuo Nakamura Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629139274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 S EL DORADO ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952061343",
            "telephone_number": "209-462-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 S EL DORADO ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952061343",
            "telephone_number": "209-462-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "ROBERT",
        "middle_name": "MITSUO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "20774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "B20774",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R",
            "last_name": "NAKAMURA",
            "middle_name": "MITSUO",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Simeah Angelique Najar
• Alexandria Najera Aguayo
• Naju Dah DME Medical Corporation
• Robert Paul Nakaki, DDS
• Darin K Nakamura, D.D.S.
• Alan S Nakanishi, M.D.
• Corey Michael Nakata, RPH
• Bhagya Nakka, MD
• Siva Pavani Nallam, MD
• Namaste Counseling Services

• General Practice Dentistry in Stockton, CA
• Providers in Stockton, 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.