Provider Demographics
NPI:1558552653
Name:INOUYE, CRAIG (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:INOUYE
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 1:11239 TAMPA AVE
Mailing Address - Street 2:#208
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1615
Mailing Address - Country:US
Mailing Address - Phone:818-368-6266
Mailing Address - Fax:818-366-2491
Practice Address - Street 1:11239 TAMPA AVE
Practice Address - Street 2:#208
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91326-1615
Practice Address - Country:US
Practice Address - Phone:818-368-6266
Practice Address - Fax:818-366-2491
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28723122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist