Individual provider Active NPI

Edward Kumasaki, D.D.S.

  • General Practice Dentistry
  • Sacramento, CA
National Provider Identifier
1962589168
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23529 Issued in CA
Practice address
925 Secret River Dr
Suite D
Sacramento, CA 95831-3465
Phone
(916) 395-3660
Fax
(916) 392-4285
NPI assigned
Nov 1, 2006
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
General Practice Dentistry 1223G0001X 23529 CA Primary

Addresses

Primary practice location

925 Secret River Dr
Suite D
Sacramento, CA 95831-3465

Mailing address

925 Secret River Dr
Suite D
Sacramento, CA 95831-3465
Phone (916) 395-3660

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

State licenses

LicenseStateTypeSpecialty
23529CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962589168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 SECRET RIVER DR",
            "address_2": "SUITE D",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958313465",
            "telephone_number": "916-395-3660",
            "fax_number": "916-392-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 SECRET RIVER DR",
            "address_2": "SUITE D",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958313465",
            "telephone_number": "916-395-3660",
            "fax_number": "916-392-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMASAKI",
        "first_name": "EDWARD",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "23529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.