Provider Demographics
NPI:1083823819
Name:INOUYE, ALLEN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:E
Last Name:INOUYE
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 1:1304 15TH ST STE 408
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1813
Mailing Address - Country:US
Mailing Address - Phone:310-395-8563
Mailing Address - Fax:310-395-5674
Practice Address - Street 1:1304 15TH ST STE 408
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1813
Practice Address - Country:US
Practice Address - Phone:310-395-8563
Practice Address - Fax:310-395-5674
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA382971223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics