Provider Demographics
NPI:1568833440
Name:KADOWAKI, TOM T (DDS)
Entity Type:Individual
Prefix:DR
First Name:TOM
Middle Name:T
Last Name:KADOWAKI
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:PO BOX 748
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-0748
Mailing Address - Country:US
Mailing Address - Phone:714-952-2156
Mailing Address - Fax:714-952-2159
Practice Address - Street 1:9955 WALKER ST
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-3827
Practice Address - Country:US
Practice Address - Phone:714-952-2156
Practice Address - Fax:714-952-2159
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-17
Last Update Date:2015-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA284621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice