Provider Demographics
NPI:1154050409
Name:FUJII, KEISHI (DDS)
Entity Type:Individual
Prefix:
First Name:KEISHI
Middle Name:
Last Name:FUJII
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 1:16604 S CURTIS RD
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-8521
Mailing Address - Country:US
Mailing Address - Phone:681-209-7386
Mailing Address - Fax:
Practice Address - Street 1:2121 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2207
Practice Address - Country:US
Practice Address - Phone:681-209-7386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE613092491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice