Provider Demographics
NPI:1194984104
Name:NARITA, MAKI (DDS)
Entity type:Individual
Prefix:DR
First Name:MAKI
Middle Name:
Last Name:NARITA
Suffix:
Gender:F
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:PO BOX 3129
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90510-3129
Mailing Address - Country:US
Mailing Address - Phone:310-792-3914
Mailing Address - Fax:
Practice Address - Street 1:3465 TORRANCE BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5804
Practice Address - Country:US
Practice Address - Phone:319-543-7788
Practice Address - Fax:310-543-7780
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA471361223G0001X
WA83551223G0001X
AZ58361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice