Provider Demographics
NPI:1326244377
Name:ISHII, LINDEN KAZUO (DDS)
Entity Type:Individual
Prefix:MR
First Name:LINDEN
Middle Name:KAZUO
Last Name:ISHII
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 1:915 HILBY AVE
Mailing Address - Street 2:SUITE 21
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955
Mailing Address - Country:US
Mailing Address - Phone:831-394-5265
Mailing Address - Fax:831-394-8554
Practice Address - Street 1:915 HILBY AVE
Practice Address - Street 2:SUITE 21
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955
Practice Address - Country:US
Practice Address - Phone:831-394-5265
Practice Address - Fax:831-394-8554
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA357351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice