Provider Demographics
NPI:1811015019
Name:KIGAWA, STEVE HIROMI (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:HIROMI
Last Name:KIGAWA
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 1:12802 W WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5120
Mailing Address - Country:US
Mailing Address - Phone:310-305-8404
Mailing Address - Fax:310-301-2094
Practice Address - Street 1:12802 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5120
Practice Address - Country:US
Practice Address - Phone:310-305-8404
Practice Address - Fax:310-301-2094
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34356122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist