Provider Demographics
NPI:1336140102
Name:KAWASUGI, KAI KEIZO (DDS)
Entity Type:Individual
Prefix:
First Name:KAI
Middle Name:KEIZO
Last Name:KAWASUGI
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 1:1547 HYACINTH WAY
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-6034
Mailing Address - Country:US
Mailing Address - Phone:303-499-9125
Mailing Address - Fax:
Practice Address - Street 1:5169 W 64TH AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-6531
Practice Address - Country:US
Practice Address - Phone:303-926-4050
Practice Address - Fax:303-426-4634
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO88041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice