Provider Demographics
NPI:1427384833
Name:TRENT J KANEMAKI DDS INC
Entity Type:Organization
Organization Name:TRENT J KANEMAKI DDS INC
Other - Org Name:HITOMI DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:KANEMAKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-443-5900
Mailing Address - Street 1:11525 LAMBERT AVE
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-1842
Mailing Address - Country:US
Mailing Address - Phone:626-443-5900
Mailing Address - Fax:
Practice Address - Street 1:11525 LAMBERT AVE
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-1842
Practice Address - Country:US
Practice Address - Phone:626-443-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA493431223G0001X
CA542451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty