Provider Demographics
NPI:1053658476
Name:KANAGAKI, DEBRA BARKER (RDHAP)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:BARKER
Last Name:KANAGAKI
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5542 MONTEREY HWY # 336
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-1529
Mailing Address - Country:US
Mailing Address - Phone:408-234-0678
Mailing Address - Fax:408-629-5013
Practice Address - Street 1:5542 MONTEREY HWY # 336
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138-1529
Practice Address - Country:US
Practice Address - Phone:408-234-0678
Practice Address - Fax:408-629-5013
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP154124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist