Provider Demographics
NPI:1356096523
Name:TOSHI HART DDS INC
Entity Type:Organization
Organization Name:TOSHI HART DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOSHIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-543-6937
Mailing Address - Street 1:4213 DALE RD # B6
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-8505
Mailing Address - Country:US
Mailing Address - Phone:209-543-6937
Mailing Address - Fax:209-297-4406
Practice Address - Street 1:4213 DALE RD # B6
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-8505
Practice Address - Country:US
Practice Address - Phone:209-543-6937
Practice Address - Fax:209-297-4406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty