Provider Demographics
NPI:1982779146
Name:MAKISHIMA, CRAIG STANLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:STANLEY
Last Name:MAKISHIMA
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 1:930 FLORIN RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-5001
Mailing Address - Country:US
Mailing Address - Phone:916-422-2722
Mailing Address - Fax:916-422-0351
Practice Address - Street 1:1355 FLORIN ROAD
Practice Address - Street 2:SUITE 4
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-4231
Practice Address - Country:US
Practice Address - Phone:916-422-2722
Practice Address - Fax:916-422-0351
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0336271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice