Provider Demographics
NPI:1073785218
Name:KUMABE, ROBERT A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:KUMABE
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 1:2238 BAYVIEW HEIGHTS DR
Mailing Address - Street 2:SUITE #N
Mailing Address - City:LOS OSOS
Mailing Address - State:CA
Mailing Address - Zip Code:93402-3937
Mailing Address - Country:US
Mailing Address - Phone:805-528-4144
Mailing Address - Fax:805-528-4663
Practice Address - Street 1:2238 BAYVIEW HEIGHTS DR
Practice Address - Street 2:SUITE #N
Practice Address - City:LOS OSOS
Practice Address - State:CA
Practice Address - Zip Code:93402-3937
Practice Address - Country:US
Practice Address - Phone:805-528-4144
Practice Address - Fax:805-528-4663
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26666122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist