Provider Demographics
NPI:1477677334
Name:YOSHIKAWA, RICHARD TOYOO (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:TOYOO
Last Name:YOSHIKAWA
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 1:9 SCHOOL ST
Mailing Address - Street 2:P.O. BOX 432
Mailing Address - City:RANDOLPH
Mailing Address - State:VT
Mailing Address - Zip Code:05060-1177
Mailing Address - Country:US
Mailing Address - Phone:802-728-3008
Mailing Address - Fax:802-728-3008
Practice Address - Street 1:9 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:VT
Practice Address - Zip Code:05060-1177
Practice Address - Country:US
Practice Address - Phone:802-728-3008
Practice Address - Fax:802-728-3008
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0000770122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0002403Medicaid