Provider Demographics
NPI:1558636340
Name:HIRAMATSU, DENNIS WAYNE (DDS)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:WAYNE
Last Name:HIRAMATSU
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 1:10 BAKER STREET
Mailing Address - Street 2:
Mailing Address - City:WINTERS
Mailing Address - State:CA
Mailing Address - Zip Code:95694
Mailing Address - Country:US
Mailing Address - Phone:530-795-4137
Mailing Address - Fax:530-795-4137
Practice Address - Street 1:10 BAKER STREET
Practice Address - Street 2:
Practice Address - City:WINTERS
Practice Address - State:CA
Practice Address - Zip Code:95694
Practice Address - Country:US
Practice Address - Phone:530-795-4137
Practice Address - Fax:530-795-4137
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24985122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist