Active NPI
Mizuki Cheryl Tadokoro, D.D.S.
- Dentist
- San Clemente, CA
National Provider Identifier
1992242275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 101055
- Practice address
- 943 Avenida Pico
Suite a
San Clemente, CA 92673-3913 - Phone
- (714) 785-2199
- NPI assigned
- Jan 25, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 101055 | CA | Primary |
Addresses
Primary practice location
943 Avenida Pico
Suite a
San Clemente, CA 92673-3913
Mailing address
206 Almador
Irvine, CA 92614-8409
Phone (714) 785-2199
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
| License | State | Type | Specialty |
|---|---|---|---|
| 101055 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485302400000",
"number": "1992242275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 ALMADOR",
"city": "IRVINE",
"state": "CA",
"postal_code": "926148409",
"telephone_number": "714-785-2199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "943 AVENIDA PICO",
"address_2": "SUITE A",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926733913",
"telephone_number": "714-785-2199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TADOKORO",
"first_name": "MIZUKI",
"middle_name": "CHERYL",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-25",
"last_updated": "2017-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "101055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Clemente, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.