Provider Demographics
NPI:1598773129
Name:MIYASAKI, CHRISTINE RIMI KOBAYASHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:RIMI KOBAYASHI
Last Name:MIYASAKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:KOBAYASHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:111 DEERWOOD RD #135
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583
Mailing Address - Country:US
Mailing Address - Phone:925-806-0322
Mailing Address - Fax:925-806-0310
Practice Address - Street 1:111 DEERWOOD RD #135
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583
Practice Address - Country:US
Practice Address - Phone:925-806-0322
Practice Address - Fax:925-806-0310
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA468451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry