Individual provider Active NPI

Misako Hirota, D.M.D.

  • Dentist
  • National City, CA
National Provider Identifier
1790782811
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
35117 Issued in CA
Practice address
135 Civic Center Dr Ste 102
National City, CA 91950-4357
Phone
(619) 474-4695
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 35117 CA Primary

Addresses

Primary practice location

135 Civic Center Dr Ste 102
National City, CA 91950-4357

Mailing address

135 Civic Center Dr Ste 102
National City, CA 91950-4357
Phone (619) 474-4695

Other identifiers 1

IdentifierTypeStateIssuer
G92697-01MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150617002202 CA Order and Referring Only - Other (Non-Physician) 7618288622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35117CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
M Hirota DMD a Dental Corporation Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1790782811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 CIVIC CENTER DR STE 102",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919504357",
            "telephone_number": "619-474-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 CIVIC CENTER DR STE 102",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919504357",
            "telephone_number": "619-474-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIROTA",
        "first_name": "MISAKO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "35117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G92697-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.