Provider Demographics
NPI:1629194832
Name:KATAYAMA, RODNEY SADAYOSHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:SADAYOSHI
Last Name:KATAYAMA
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 1:65 N. HWY 101
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WARRENTON
Mailing Address - State:OR
Mailing Address - Zip Code:97146
Mailing Address - Country:US
Mailing Address - Phone:503-325-2031
Mailing Address - Fax:
Practice Address - Street 1:65 N HIGHWAY 101
Practice Address - Street 2:SUITE 212
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146-9371
Practice Address - Country:US
Practice Address - Phone:503-325-2031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD86671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice