Provider Demographics
NPI:1407236151
Name:NAGAO, JOSHUA K (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:K
Last Name:NAGAO
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 1:3922 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-3276
Mailing Address - Country:US
Mailing Address - Phone:801-660-0048
Mailing Address - Fax:
Practice Address - Street 1:3922 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-3276
Practice Address - Country:US
Practice Address - Phone:801-660-0048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD009249122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist