Active NPI
Mina Nishimoto, DDS, MS
- Dentist
- Loma Linda, CA
National Provider Identifier
1891244943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60537943
- Practice address
- 11092 Anderson St
Loma Linda, CA 92350-1706 - Phone
- (909) 558-4222
- NPI assigned
- Sep 30, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE60537943 | WA | Primary |
Addresses
Primary practice location
11092 Anderson St
Loma Linda, CA 92350-1706
Mailing address
25334 Cole St
Loma Linda, CA 92354-3104
Phone (909) 705-2110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE60537943 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475193600000",
"number": "1891244943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25334 COLE ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543104",
"telephone_number": "909-705-2110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11092 ANDERSON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501706",
"telephone_number": "909-558-4222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NISHIMOTO",
"first_name": "MINA",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-30",
"last_updated": "2016-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60537943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.