Provider Demographics
NPI:1952478380
Name:NAKAMURA, MORRIS KATSUYOSHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:KATSUYOSHI
Last Name:NAKAMURA
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 1:17437 CHATSWORTH STREET
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5718
Mailing Address - Country:US
Mailing Address - Phone:818-368-6694
Mailing Address - Fax:818-368-6695
Practice Address - Street 1:17437 CHATSWORTH STREET
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5718
Practice Address - Country:US
Practice Address - Phone:818-368-6694
Practice Address - Fax:818-368-6695
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18598122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist