Theodore R. Okazaki DDS, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

37717 Issued in CA

Legal business name

THEODORE R. OKAZAKI DDS, INC

Practice address

3950 Stevenson Place
#219
Fremont, CA 94539

Phone

(510) 794-9999

Fax

(510) 797-7460

NPI assigned

Apr 6, 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. Theodore R. Okazaki, DDSNPI 1700164530

Title

Owner

Phone

(510) 794-9999

Specialties & licenses 1

Addresses

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.

• Theodore Ryu Okazaki, DDS

  • Dentist
  • Fremont, CA
  • NPI 1700164530
  Authorized official Same address or phone

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801918990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 STEVENSON PLACE",
            "address_2": "#219",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "94539",
            "telephone_number": "510-794-9999",
            "fax_number": "510-797-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 STEVENSON PLACE",
            "address_2": "#219",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "94539",
            "telephone_number": "510-794-9999",
            "fax_number": "510-797-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE R. OKAZAKI DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OKAZAKI",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-794-9999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Fremont, CA
• Providers in Fremont, 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.