MAMORU TANAKA D.D.S FACP NPI 1265717391

NPI Information

NPI: 1265717391
Provider Name: MAMORU TANAKA, D.D.S, FACP
Classification: Dentist - 1223P0700X
Entity Type: Individual

Specialization: Prosthodontics

Address:
8008 FROST ST # 800
SAN DIEGO, CA
ZIP 92123
Phone: (617) 459-9491
Get Directions

Mamoru Tanaka, D.D.S, FACP is a prosthodontics dentist in San Diego, CA. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. Mamoru Tanaka, D.D.S, FACP NPI is 1265717391. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8008 FROST ST # 800
SAN DIEGO, CA
ZIP 92123-205
Phone: (617) 459-9491

The enumeration date for this NPI number is 10/20/2011 and was last updated on 11/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0700X	Dentist	Prosthodontics	101517	CALIFORNIA	Yes
2	1223P0700X	Dentist	Prosthodontics	31503	TEXAS	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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