Provider Demographics
NPI:1720016025
Name:AKIMOTO, NOBUHIKO JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NOBUHIKO
Middle Name:JOHN
Last Name:AKIMOTO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:N.
Other - Middle Name:JOHN
Other - Last Name:AKIMOTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:10212 PARK VIEW CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-3122
Mailing Address - Country:US
Mailing Address - Phone:952-884-3358
Mailing Address - Fax:
Practice Address - Street 1:1305 E 66TH ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2643
Practice Address - Country:US
Practice Address - Phone:612-869-0151
Practice Address - Fax:612-869-1052
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN71651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice