Provider Demographics
NPI:1295461440
Name:KARASHIMA, MOMOKO (DSS)
Entity Type:Individual
Prefix:
First Name:MOMOKO
Middle Name:
Last Name:KARASHIMA
Suffix:
Gender:F
Credentials:DSS
Other - Prefix:
Other - First Name:MOMOKO
Other - Middle Name:
Other - Last Name:HARADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5398 AUBREY LOOP
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-5284
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:POSTLE HALL
Practice Address - Street 2:305 W.12TH AVENUE
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1267
Practice Address - Country:US
Practice Address - Phone:614-292-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.004525122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist