Provider Demographics
NPI:1164649380
Name:FUJIMURA, GUILLERMO (DDS)
Entity Type:Individual
Prefix:DR
First Name:GUILLERMO
Middle Name:
Last Name:FUJIMURA
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 1:421 S VENTURA RD
Mailing Address - Street 2:SUITE 40
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-6551
Mailing Address - Country:US
Mailing Address - Phone:805-382-8000
Mailing Address - Fax:805-382-8002
Practice Address - Street 1:421 S VENTURA RD
Practice Address - Street 2:SUITE 40
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-6551
Practice Address - Country:US
Practice Address - Phone:805-382-8000
Practice Address - Fax:805-382-8002
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38283122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist