Provider Demographics
NPI:1972624526
Name:TASHIRO, GEORGE ROBERT (DDS)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:ROBERT
Last Name:TASHIRO
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 1:12357 FELSON PLACE
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703
Mailing Address - Country:US
Mailing Address - Phone:562-653-1125
Mailing Address - Fax:
Practice Address - Street 1:558 E WARDLOW RD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4537
Practice Address - Country:US
Practice Address - Phone:562-427-1221
Practice Address - Fax:562-997-8959
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23388122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist