Provider Demographics
NPI:1134527971
Name:HATTA TSUJI, ERI
Entity type:Individual
Prefix:
First Name:ERI
Middle Name:
Last Name:HATTA TSUJI
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ERI
Other - Middle Name:
Other - Last Name:HATTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:735 SANTA CLARA AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3317
Mailing Address - Country:US
Mailing Address - Phone:510-523-6281
Mailing Address - Fax:
Practice Address - Street 1:735 SANTA CLARA AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-3317
Practice Address - Country:US
Practice Address - Phone:510-523-6281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48811122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist