Provider Demographics
NPI:1497961304
Name:SAKABE, MARK (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:SAKABE
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 1:17692 BEACH BLVD
Mailing Address - Street 2:310
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6837
Mailing Address - Country:US
Mailing Address - Phone:714-842-5035
Mailing Address - Fax:714-841-3772
Practice Address - Street 1:17692 BEACH BLVD
Practice Address - Street 2:310
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6837
Practice Address - Country:US
Practice Address - Phone:714-842-5035
Practice Address - Fax:714-841-3772
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA342061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice