Provider Demographics
NPI:1750968434
Name:AKIMOTO, HITOMI
Entity type:Individual
Prefix:
First Name:HITOMI
Middle Name:
Last Name:AKIMOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11109 NE 91ST LN
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5721
Mailing Address - Country:US
Mailing Address - Phone:425-698-3114
Mailing Address - Fax:
Practice Address - Street 1:11109 NE 91ST LN
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5721
Practice Address - Country:US
Practice Address - Phone:425-698-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-27
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000109181223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics