NPIMap

Organization Active NPI

Phyllis K. Kawada, DDS, Ms, a Professional Corporation

  • Dental Clinic/Center
  • Chino Hills, CA
National Provider Identifier
1639653009
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PHYLLIS K. KAWADA, DDS, MS, A PROFESSIONAL CORPORATION
Practice address
15944 Los Serranos Country Club Dr Ste 100
Chino Hills, CA 91709-3254
Phone
(909) 393-3311
Fax
(909) 393-3343
NPI assigned
Sep 20, 2018
Last updated
Sep 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Authorized official

Name
Dr. Phyllis Kazumi Kawada, DDSNPI 1144331323
Title
President/Owner
Phone
(562) 690-3750

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

15944 Los Serranos Country Club Dr Ste 100
Chino Hills, CA 91709-3254

Mailing address

15944 Los Serranos Country Club Dr Ste 100
Chino Hills, CA 91709-3254
Phone (909) 393-3311

National Provider Directory

National Provider Directory
Tax ID family
Center for Pediatric Dentistry3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15944 Los Serranos Country Club Dr
Ste 100
Chino Hills, CA 91709
Phone (909) 393-3311

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1639653009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15944 LOS SERRANOS COUNTRY CLUB DR STE 100",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093254",
            "telephone_number": "909-393-3311",
            "fax_number": "909-393-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15944 LOS SERRANOS COUNTRY CLUB DR STE 100",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093254",
            "telephone_number": "909-393-3311",
            "fax_number": "909-393-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYLLIS K. KAWADA, DDS, MS, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "KAWADA",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "KAZUMI",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "562-690-3750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.