Provider Demographics
NPI:1629244835
Name:SHIOSAKY, DENISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:SHIOSAKY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2482 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2415
Mailing Address - Country:US
Mailing Address - Phone:415-660-5897
Mailing Address - Fax:415-800-7559
Practice Address - Street 1:2482 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2415
Practice Address - Country:US
Practice Address - Phone:415-660-5897
Practice Address - Fax:415-800-7559
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55202122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist