Provider Demographics
NPI:1760796700
Name:SAKA, HIROSHI (DMD)
Entity Type:Individual
Prefix:
First Name:HIROSHI
Middle Name:
Last Name:SAKA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12660 HILLCREST RD APT 8206
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2029
Mailing Address - Country:US
Mailing Address - Phone:954-465-0816
Mailing Address - Fax:
Practice Address - Street 1:3010 LBJ FWY STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-2723
Practice Address - Country:US
Practice Address - Phone:972-444-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2019-10-29
Deactivation Date:2019-10-28
Deactivation Code:
Reactivation Date:2019-10-29
Provider Licenses
StateLicense IDTaxonomies
TX258301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice