Individual provider Active NPI

Ellen Yukiko Hayashi, D.D.S.

  • Periodontics
  • Redondo Beach, CA
National Provider Identifier
1841407772
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
33699 Issued in CA
Practice address
1921 S Catalina Ave
Suite 3
Redondo Beach, CA 90277-5516
Phone
(310) 375-8012
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 33699 CA Primary

Addresses

Primary practice location

1921 S Catalina Ave
Suite 3
Redondo Beach, CA 90277-5516

Mailing address

1921 S Catalina Ave
Suite 3
Redondo Beach, CA 90277-5516
Phone (310) 375-8012

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160607000010 CA Order and Referring Only - DentistPractitioner - Dentist 4385934116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33699CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Keith T Komatsu DDS Apc PastSince Jun 15, 2021 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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841407772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 S CATALINA AVE",
            "address_2": "SUITE 3",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775516",
            "telephone_number": "310-375-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 S CATALINA AVE",
            "address_2": "SUITE 3",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775516",
            "telephone_number": "310-375-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYASHI",
        "first_name": "ELLEN",
        "middle_name": "YUKIKO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "33699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.