Deric Denroku Ikuta, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53801 Issued in CA

Practice address

1112 C Street
Reedley, CA 93654-3015

Phone

(559) 638-6321

Fax

(559) 638-5014

NPI assigned

May 22, 2008

Sex

Male

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1760649073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 C STREET",
            "city": "REEDLEY",
            "state": "CA",
            "postal_code": "936543015",
            "telephone_number": "559-638-6321",
            "fax_number": "559-638-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 C STREET",
            "city": "REEDLEY",
            "state": "CA",
            "postal_code": "936543015",
            "telephone_number": "559-638-6321",
            "fax_number": "559-638-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKUTA",
        "first_name": "DERIC",
        "middle_name": "DENROKU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-22",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope and Wellness Family Therapy, Inc.
• Marisol Graciela Howlett
• Kristie Hang Huynh, PHARMD
• Nancy Huynh
• Dennis D Ikuta, DDI
• Frank Lynn Ikuta, D.D.S.
• Ren Imai, MD
• Imgrx SJ Valley, Inc. (United Health Centers Pharmacy Reedley)
• Henry Uchechukwuka Iwebor, RPH
• Lindsay Lea Jacobs, M.P.T.,P.T.

• General Practice Dentistry in Reedley, CA
• Providers in Reedley, 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 Jan 6, 2015; 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.