Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mamoru Tanaka, DDS, FACP

Individual provider Prosthodontics · NPI 1265717391

Mamoru Tanaka, DDS, FACP is a Prosthodontics in San Diego, California. Practices as a sole proprietor. Licensed in California and Texas.

Licensed in
CA, TX
In the registry since
2011
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.
FACP — Fellow of the American College of Physicians
An internist admitted as a fellow of the ACP.

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Practice location Address checks out

8008 Frost St # 800
San Diego, CA 92123-4205
Phone: (617) 459-9491
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthodontics (primary) Taxonomy 1223P0700X · Licence 101517 (CA)
Prosthodontics Taxonomy 1223P0700X · Licence 31503 (TX)

Record details

NPI number1265717391
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS , FACP
Sole proprietorYes
NPI enumeratedOctober 20, 2011
Last updated in NPPESNovember 22, 2022
Certification dateNovember 22, 2022

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