Provider Demographics
NPI:1114006590
Name:KAWAMOTO, RICHARD DENNIS (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DENNIS
Last Name:KAWAMOTO
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 1:727 N 182ND ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4402
Mailing Address - Country:US
Mailing Address - Phone:206-546-2424
Mailing Address - Fax:206-546-2425
Practice Address - Street 1:727 N 182ND ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4402
Practice Address - Country:US
Practice Address - Phone:206-546-2424
Practice Address - Fax:206-546-2425
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4096122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist