Provider Demographics
NPI:1962669903
Name:KUMAGAI, SHARON ELAINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:ELAINA
Last Name:KUMAGAI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5175 E PACIFIC COAST HWY STE 305
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3316
Mailing Address - Country:US
Mailing Address - Phone:562-494-1853
Mailing Address - Fax:
Practice Address - Street 1:5175 E PACIFIC COAST HWY STE 305
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3316
Practice Address - Country:US
Practice Address - Phone:562-494-1853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA375701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice