Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1730233198 Deactivated / Inactive NPI Male Practitioner

Dr. Sam Isamu Kodama , DDS

Dentist • Fresno, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Sam Kodama has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 23, 2007
NPI Deactivation Date June 12, 2025
Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Sam Kodama, DDS was a registered Dentist practicing in Fresno, CA. Throughout an active medical career spanning 18 years, Dr. Kodama provided care at the practice location at 7225 N FIRST ST until profile deactivation on 2025-06-12.

Practice Location & Contact Primary Location

Practice Address

7225 N First St
107

Fresno, CA 937202964

Telephone 5594313806
Fax 5594316832
Associated Practice Facility / Clinic
🏢 Clayton T. Kodama, Dds, Inc. Facility NPI 1942692579

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Fresno, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.0 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
193 Specialists

Practicing in Fresno, CA (15331 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 17716

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1174689129

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 12, 2025

Record deactivated on June 12, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 7225 N FIRST ST, 107, FRESNO, CA 937202964 (Tel: 5594313806)

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Updated Business Mailing Address July 08, 2007

Registered at 7225 N FIRST ST, 107, FRESNO, CA 937202964 (Tel: 5594313806)

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Provider Name / Credentials Updated July 08, 2007

Recorded as SAM KODAMA, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #17716 in CA)

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Initial NPI Registration & Enumeration January 23, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730233198
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 23, 2007
Last Update: July 08, 2007
Deactivation Date: June 12, 2025

Mailing Address

7225 N First St, 107

Fresno, CA 937202964

Phone: 5594313806

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.