Provider Demographics
NPI:1851503437
Name:NELSON PAI DDS & SUSAN ISHIOKA DDS MS, INC.
Entity Type:Organization
Organization Name:NELSON PAI DDS & SUSAN ISHIOKA DDS MS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:
Authorized Official - Last Name:PAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-493-2807
Mailing Address - Street 1:5122 KATELLA AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2826
Mailing Address - Country:US
Mailing Address - Phone:562-493-2807
Mailing Address - Fax:
Practice Address - Street 1:5122 KATELLA AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2826
Practice Address - Country:US
Practice Address - Phone:562-493-2807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA345401223G0001X
CA355061223P0221X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty