Provider Demographics
NPI:1568714236
Name:HITOMI DENTISTRY
Entity Type:Organization
Organization Name:HITOMI DENTISTRY
Other - Org Name:TRENT JON KANEMAKI DDS
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPATKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
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:626-443-2674
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:626-443-2674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49343261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1851354021OtherTRENT KANEMAKI'S NPI