Provider Demographics
NPI:1578788865
Name:NAKATANI, CLIFTON EIJI (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:CLIFTON
Middle Name:EIJI
Last Name:NAKATANI
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 SECRET RIVER DR
Mailing Address - Street 2:SUITE J
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3465
Mailing Address - Country:US
Mailing Address - Phone:916-421-5555
Mailing Address - Fax:916-421-7101
Practice Address - Street 1:925 SECRET RIVER DR
Practice Address - Street 2:SUITE J
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3465
Practice Address - Country:US
Practice Address - Phone:916-421-5555
Practice Address - Fax:916-421-7101
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347441223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics