Individual provider Active NPI

Mark Isamu Uyehara, D.D.S.

  • Dentist
  • Sylmar, CA
National Provider Identifier
1942308085
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31102 Issued in CA
Practice address
15989 Yarnell St
Sylmar, CA 91342-1052
Phone
(818) 362-1563
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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
Dentist 122300000X 31102 CA Primary

Addresses

Primary practice location

15989 Yarnell St
Sylmar, CA 91342-1052

Mailing address

15989 Yarnell St
Sylmar, CA 91342-1052
Phone (818) 362-1563

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
I20161123001192 CA Order and Referring Only - DentistPractitioner - Dentist 4385923986

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942308085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15989 YARNELL ST",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421052",
            "telephone_number": "818-362-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15989 YARNELL ST",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421052",
            "telephone_number": "818-362-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UYEHARA",
        "first_name": "MARK",
        "middle_name": "ISAMU",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "31102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.