NPIMap

Organization Active NPI

K Itoh DDS Inc

Doing business as Bleach Dental

  • Dental Clinic/Center
  • Fountain Valley, CA
National Provider Identifier
1720692890
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
K ITOH DDS INC
Doing business as
Bleach Dental
Practice address
11100 Warner Ave Ste 160
Fountain Valley, CA 92708-7510
Phone
(714) 799-9945
Fax
(657) 218-9699
NPI assigned
Sep 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
Dr. Kouichi Cliff Itoh, DDSNPI 1063633113
Title
Dentist
Phone
(714) 799-9945

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

11100 Warner Ave Ste 160
Fountain Valley, CA 92708-7510

Mailing address

11100 Warner Ave Ste 160
Fountain Valley, CA 92708-7510
Phone (714) 799-9945

Other names 1

  • Bleach Dental Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL bleachdental@gmail.com Direct

National Provider Directory

National Provider Directory

Locations

11100 Warner Ave
Ste 160
Fountain Valley, CA 92708
Phone (714) 799-9945

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1720692890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE STE 160",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087510",
            "telephone_number": "714-799-9945",
            "fax_number": "657-218-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE STE 160",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087510",
            "telephone_number": "714-799-9945",
            "fax_number": "657-218-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K ITOH DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "ITOH",
        "authorized_official_first_name": "KOUICHI",
        "authorized_official_middle_name": "CLIFF",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "714-799-9945",
        "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": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "bleachdental@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11100 Warner Ave Ste 160",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927087510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bleach Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bleach Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.