Individual provider Active NPI

Michael K Iwaoka, D.D.S.

  • General Practice Dentistry
  • White Plains, NY
National Provider Identifier
1629170220
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
041686-1 Issued in NY
Practice address
56 Doyer Ave
Suite #1a
White Plains, NY 10605-1639
Phone
(914) 421-1188
Fax
(914) 686-3060
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 041686-1 NY Primary

Addresses

Primary practice location

56 Doyer Ave
Suite #1a
White Plains, NY 10605-1639

Mailing address

56 Doyer Ave
Suite #1a
White Plains, NY 10605-1639
Phone (914) 421-1188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041686-1NYMDGeneral Practice Dentistry
041686NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gary L. Lighter,D.M.D. Robert M. Amante,D.M.D.,P.C. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629170220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 DOYER AVE",
            "address_2": "SUITE #1A",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051639",
            "telephone_number": "914-421-1188",
            "fax_number": "914-686-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 DOYER AVE",
            "address_2": "SUITE #1A",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051639",
            "telephone_number": "914-421-1188",
            "fax_number": "914-686-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWAOKA",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "041686-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • 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.