Laura Takahashi Deyo, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

61169 Issued in CA

Practice address

1293 Holmgrove Dr
San Marcos, CA 92078-2800

Phone

(310) 913-9013

NPI assigned

Apr 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: lharshbarger@direct.westerndental.com

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.

• Deyo Dental Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Marcos, CA
  • NPI 1154159408
  NPD Authorized official

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1659637973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1293 HOLMGROVE DR",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782800",
            "telephone_number": "310-913-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1293 HOLMGROVE DR",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782800",
            "telephone_number": "310-913-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYO",
        "first_name": "LAURA",
        "middle_name": "TAKAHASHI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "61169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrett Robert Desrosiers, PT, DPT
• Kayleigh Ann Desrosiers, PT, DPT
• Destinations Direct Primary Care
• Alexandra Dexter
• Deyo Dental Corporation
• Rachel Piazza Dezember, LCSW
• Riti Di Angeli
• Shannon Di Pietro
• Diabetic Foot & Wound Treatment Centers
• Diabetic Foot & Wound Treatment Centers

• Orthodontics and Dentofacial Orthopedics Dentistry in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.

Verify at the official NPI Registry.