Provider Demographics
NPI:1770567570
Name:INOUYE, KIMBERLY ANN SAYA (DMD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANN SAYA
Last Name:INOUYE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 HOFF STREET
Mailing Address - Street 2:USA DENTAC
Mailing Address - City:FT BENNING
Mailing Address - State:GA
Mailing Address - Zip Code:31905
Mailing Address - Country:US
Mailing Address - Phone:706-544-4530
Mailing Address - Fax:706-544-1933
Practice Address - Street 1:7101 HOFF STREET
Practice Address - Street 2:USA DENTAC
Practice Address - City:FT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905
Practice Address - Country:US
Practice Address - Phone:706-544-4530
Practice Address - Fax:706-544-1933
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2166122300000X
HIDT-21661223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist