Provider Demographics
NPI:1033977509
Name:KASAI, DAVID RYAN
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:RYAN
Last Name:KASAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10S240 SUFFIELD DR
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-5183
Mailing Address - Country:US
Mailing Address - Phone:630-202-5830
Mailing Address - Fax:
Practice Address - Street 1:10S240 SUFFIELD DR
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-5183
Practice Address - Country:US
Practice Address - Phone:630-202-5830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126900000XDental ProvidersDental Laboratory Technician