Provider Demographics
NPI:1952511487
Name:HUTCHINSON, KEIKO KAREN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEIKO
Middle Name:KAREN
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 ALPINE DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4233
Mailing Address - Country:US
Mailing Address - Phone:973-706-6616
Mailing Address - Fax:
Practice Address - Street 1:66 NEWARK POMPTON TPKE
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:NJ
Practice Address - Zip Code:07457-1420
Practice Address - Country:US
Practice Address - Phone:973-835-1195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI161311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice