Kiyomi Yamazaki, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

52484 Issued in CA

Practice address

1143 W Gardena Blvd
Gardena, CA 90247-4823

Phone

(310) 327-9130

Fax

(310) 327-9146

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Children's Hospital Los Angeles Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1265530653
  Medicare reassignment NPD
• Kiyomi Yamazaki, DDS, Inc

  dba Gardena Family Dental

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Gardena, CA
  • NPI 1487987582

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252195200000",
    "number": "1790870236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 W GARDENA BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474823",
            "telephone_number": "310-327-9130",
            "fax_number": "310-327-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 W GARDENA BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474823",
            "telephone_number": "310-327-9130",
            "fax_number": "310-327-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAZAKI",
        "first_name": "KIYOMI",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D52484",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ron H Yamane, M.D.
• Yoko Yamane
• Robert Yamasaki, D.D.S.
• Jeffrey Yasunori Yamashiro, DDS
• Bryce Kiyoshi Yamauchi, DPM
• Yan Yampolsky, DMD
• Andrew Jancy Yan
• Shuichi Yanagidaira
• Eunho Yang, L.AC
• Jina Ko Yang, NP

• General Practice Dentistry in Gardena, CA
• Providers in Gardena, 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 Sep 6, 2009; 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.