DR. GARY NORIAKI KITAZAWA D.D.S.
NPI 1972695864
Dentist - Periodontics in Los Angeles, CA

Q: What is Gary Kitazawa's NPI number?

The NPI number for Gary Kitazawa is 1972695864. It was assigned to this individual provider in the NPPES registry on September 28, 2006.

Q: What is Gary Kitazawa's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: When was this NPI record last updated?

The NPPES record for Gary Kitazawa was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 28, 2006PECOS Enrolled

1127 WILSHIRE BLVD, SUITE 404, LOS ANGELES, CA 90017(213) 481-1127(213) 481-1510 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Gary Noriaki Kitazawa D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GARY NORIAKI KITAZAWA D.D.S. (NPI 1972695864) is an individual periodontics provider in Los Angeles, California, licensed in California (23000) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972695864

Entity TypeIndividualMale

Primary Taxonomy1223P0300X

Provider Legal NameDR. GARY NORIAKI KITAZAWACredential: D.D.S.

Location Address1127 WILSHIRE BLVD, SUITE 404Los Angeles, CA 90017-3901

Mailing Address1127 Wilshire Blvd., Suite 404Los Angeles, CA 90017-3905 · (213) 481-1127 · Fax (213) 481-1510

Phone(213) 481-1127

Fax(213) 481-1510

Sole ProprietorYes

Enumeration DateSeptember 28, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1972695864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in CA · 23000

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

1127 WILSHIRE BLVD, Los Angeles, CA 90017

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Gary Noriaki Kitazawa D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90017 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.