Miyamoto and Phi Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

47291 Issued in CA

Legal business name

MIYAMOTO AND PHI DENTAL CORPORATION

Doing business as

La Jolla Del Sur Dental

Practice address

470 Nautilus St
Suite 309
La Jolla, CA 92037-5969

Phone

(858) 454-5822

NPI assigned

May 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gerald Miyamoto, D.D.S.

Title

Ceo

Phone

(858) 454-5822

Specialties & licenses 1

Addresses

Other names 1

• La Jolla Del Sur Dental Doing business as

Locations

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.

• Tiffany Phi, D.D.S.

  • General Practice Dentistry
  • La Jolla, CA
  • NPI 1992913743
  NPD (past)

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740498526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 NAUTILUS ST",
            "address_2": "SUITE 309",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375969",
            "telephone_number": "858-454-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 NAUTILUS ST",
            "address_2": "SUITE 309",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375969",
            "telephone_number": "858-454-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIYAMOTO AND PHI DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIYAMOTO",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-454-5822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Jolla Del Sur Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mission Beach Holdings LLC (La Jolla Post-Acute)
• Brendon Cranfill Mitchell, MD
• Christine Marie Mitchell, ATC
• Jacob Allen Mitchell, CCP
• Jeffrey Alan Mitchell, P.T.
• Ellen A Miyashiro, DMD
• Hirotaka Miyashita, MD
• Mari Ayako Miyoshi
• Lianne T Mizoguchi, OD
• Joseph Mizzell III, MD

• General Practice Dentistry in La Jolla, CA
• Providers in La Jolla, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.