Provider Demographics
NPI:1982824017
Name:NISHIKAWA, RICHARD TAMOTSU (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:TAMOTSU
Last Name:NISHIKAWA
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 1:23560 MADISON ST.
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4710
Mailing Address - Country:US
Mailing Address - Phone:310-530-6444
Mailing Address - Fax:310-530-9890
Practice Address - Street 1:23560 MADISON ST.
Practice Address - Street 2:SUITE 202
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4710
Practice Address - Country:US
Practice Address - Phone:310-530-6444
Practice Address - Fax:310-530-9890
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA273481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice