Provider Demographics
NPI:1942385869
Name:HIROSHIGE, NAOMI (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:
Last Name:HIROSHIGE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:HIROSHIGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:900 STANNAGE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2006
Mailing Address - Country:US
Mailing Address - Phone:510-525-2425
Mailing Address - Fax:510-525-7310
Practice Address - Street 1:900 STANNAGE AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2006
Practice Address - Country:US
Practice Address - Phone:510-525-2425
Practice Address - Fax:510-525-7310
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA409431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice