Individual provider Active NPI

Brett Tsuzaki

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1972249787
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DT-3011-0 Issued in HI
Practice address
Navy Medicine Support Command Attn: Medical Staff SVCS
BLDG H 2005 Knight Lane
Jacksonville, FL 32212
Phone
(760) 725-3213
NPI assigned
May 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DT-3011-0 HI Primary

Addresses

Primary practice location

Navy Medicine Support Command Attn: Medical Staff SVCS
BLDG H 2005 Knight Lane
Jacksonville, FL 32212

Mailing address

701 El Atajo St
Los Angeles, CA 90065-3303
Phone (808) 206-1179

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
DT-3011-0HIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1972249787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 EL ATAJO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900653303",
            "telephone_number": "808-206-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS",
            "address_2": "BLDG H 2005 KNIGHT LANE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32212",
            "telephone_number": "760-725-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSUZAKI",
        "first_name": "BRETT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT-3011-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.