NPIMap

Organization Active NPI

Kenneth S. Masumoto DDS Inc

  • Dentist
  • Fresno, CA
National Provider Identifier
1811147796
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14139 Issued in CA
Legal business name
KENNETH S. MASUMOTO DDS INC
Practice address
430 W. Shaw
Fresno, CA 93704
Phone
(559) 229-1806
Fax
(559) 229-5953
NPI assigned
Sep 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Authorized official

Name
Dr. Kenneth Sadao Masumoto, D.D.S.
Title
President
Phone
(559) 229-1806

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 14139 CA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 14139 CA

Addresses

Primary practice location

430 W. Shaw
Fresno, CA 93704

Mailing address

430 W. Shaw
Fresno, CA 93704
Phone (559) 229-1806

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1811147796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W. SHAW",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93704",
            "telephone_number": "559-229-1806",
            "fax_number": "559-229-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W. SHAW",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93704",
            "telephone_number": "559-229-1806",
            "fax_number": "559-229-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH S. MASUMOTO DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "MASUMOTO",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "SADAO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-229-1806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "14139",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "14139",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.