Active NPI
Brett M Nagatani, D.D.S.
- Endodontics
- Los Angeles, CA
National Provider Identifier
1649241092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 55266
- Practice address
- 925 W 34TH St Ste 124C
Los Angeles, CA 90089-0641 - Phone
- (213) 740-1080
- NPI assigned
- Feb 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 55266 | CA | Primary |
| Endodontics | 1223E0200X | 22375 | TX | |
| Endodontics | 1223E0200X | DT - 2276 | HI |
Addresses
Primary practice location
925 W 34TH St Ste 124C
Los Angeles, CA 90089-0641
Mailing address
11551 Amalfi Way
Porter Ranch, CA 91326-4099
Phone (323) 440-3584
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160428000562 | CA | Order and Referring Only - Other (Non-Physician) | 0840599791 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22375 | TX | MD | Clinical Social Worker |
| DT - 2276 | HI | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410480000000",
"number": "1649241092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11551 AMALFI WAY",
"city": "PORTER RANCH",
"state": "CA",
"postal_code": "913264099",
"telephone_number": "323-440-3584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 W 34TH ST STE 124C",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900890641",
"telephone_number": "213-740-1080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAGATANI",
"first_name": "BRETT",
"middle_name": "M",
"name_prefix": "Prof.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-01",
"last_updated": "2014-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "55266",
"primary": true
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "TX",
"license": "22375",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "HI",
"license": "DT - 2276",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.