Provider Demographics
NPI:1083768543
Name:WILLCOX, KEIKO H (DDS DMD PHD)
Entity Type:Individual
Prefix:DR
First Name:KEIKO
Middle Name:H
Last Name:WILLCOX
Suffix:
Gender:F
Credentials:DDS DMD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DR. KEIKO WILLCOX
Mailing Address - Street 2:7331 E OSBORN DR STE #310
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251
Mailing Address - Country:US
Mailing Address - Phone:480-947-7850
Mailing Address - Fax:480-947-7491
Practice Address - Street 1:7331 E OSBORN DR STE #310
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251
Practice Address - Country:US
Practice Address - Phone:480-947-7850
Practice Address - Fax:480-947-7491
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice