Provider Demographics
NPI:1669543195
Name:KAWAKAMI, SAM S (DDS)
Entity type:Individual
Prefix:DR
First Name:SAM
Middle Name:S
Last Name:KAWAKAMI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14062 DENVER WEST PARKWAY
Mailing Address - Street 2:#52 120
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3121
Mailing Address - Country:US
Mailing Address - Phone:303-279-5050
Mailing Address - Fax:303-279-1645
Practice Address - Street 1:14062 DENVER WEST PARKWAY
Practice Address - Street 2:#52 120
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-3121
Practice Address - Country:US
Practice Address - Phone:303-279-5050
Practice Address - Fax:303-279-1645
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104971122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist