Provider Demographics
NPI:1235664129
Name:KAWAMOTO, DARCY SUMIKO (DDS)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:SUMIKO
Last Name:KAWAMOTO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 LEAFY TWIG
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1355
Mailing Address - Country:US
Mailing Address - Phone:714-262-2651
Mailing Address - Fax:
Practice Address - Street 1:125 LEAFY TWIG
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-1355
Practice Address - Country:US
Practice Address - Phone:714-262-2651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-27
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS101928122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist