Provider Demographics
NPI:1013150838
Name:NAKAMURA GOMEZ, ERIKA (DDS)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:NAKAMURA GOMEZ
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 1:1750 E OCEAN BLVD UNIT 109
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-6017
Mailing Address - Country:US
Mailing Address - Phone:562-230-9666
Mailing Address - Fax:
Practice Address - Street 1:520 W 7TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3116
Practice Address - Country:US
Practice Address - Phone:310-832-5361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA566591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice