Midori Tachibana DDS Inc

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

MIDORI TACHIBANA DDS INC

Practice address

901 S El Camino Real
San Mateo, CA 94402-2311

Phone

(650) 375-1175

Fax

(650) 558-8476

NPI assigned

Jun 17, 2019

Organization subpart

No

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

Authorized official

Name

Midori Tachibana, DDS

Title

President

Phone

(650) 375-1175

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560729600000",
    "number": "1730749235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S EL CAMINO REAL",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022311",
            "telephone_number": "650-375-1175",
            "fax_number": "650-558-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S EL CAMINO REAL",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022311",
            "telephone_number": "650-375-1175",
            "fax_number": "650-558-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDORI TACHIBANA DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A",
        "authorized_official_last_name": "TACHIBANA",
        "authorized_official_first_name": "MIDORI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-375-1175",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.