Provider Demographics
NPI:1093127227
Name:SHIROMOTO, CHIHIRO (DDS)
Entity Type:Individual
Prefix:MR
First Name:CHIHIRO
Middle Name:
Last Name:SHIROMOTO
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 1:1033-2 KUSAKI
Mailing Address - Street 2:
Mailing Address - City:OMUTA
Mailing Address - State:FUKUOKA
Mailing Address - Zip Code:837 0917
Mailing Address - Country:JP
Mailing Address - Phone:81909-402-2029
Mailing Address - Fax:8194-453-2418
Practice Address - Street 1:1033-2 KUSAKI
Practice Address - Street 2:
Practice Address - City:OMUTA
Practice Address - State:FUKUOKA
Practice Address - Zip Code:837 0917
Practice Address - Country:JP
Practice Address - Phone:81909-402-2029
Practice Address - Fax:8194-453-2418
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program