Provider Demographics
NPI:1053446088
Name:KITAJIMA, HENRY M (DDS)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:M
Last Name:KITAJIMA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-0535
Mailing Address - Country:US
Mailing Address - Phone:925-837-1301
Mailing Address - Fax:925-837-1302
Practice Address - Street 1:185 FRONT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-3331
Practice Address - Country:US
Practice Address - Phone:925-837-1301
Practice Address - Fax:925-837-1302
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA229001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice