Provider Demographics
NPI:1467662999
Name:TOGUCHI, ALYSON MIDORI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALYSON
Middle Name:MIDORI
Last Name:TOGUCHI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3937
Mailing Address - Country:US
Mailing Address - Phone:213-386-7173
Mailing Address - Fax:213-386-7177
Practice Address - Street 1:3851 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3937
Practice Address - Country:US
Practice Address - Phone:213-386-7173
Practice Address - Fax:213-386-7177
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52122122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist