Provider Demographics
NPI:1285075911
Name:HIRADATE, SENA E (DDS)
Entity type:Individual
Prefix:
First Name:SENA
Middle Name:E
Last Name:HIRADATE
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 1:2250 W WHITTIER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-3470
Mailing Address - Country:US
Mailing Address - Phone:562-690-3750
Mailing Address - Fax:
Practice Address - Street 1:2250 W WHITTIER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-3470
Practice Address - Country:US
Practice Address - Phone:562-690-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA605061223P0221X
HICSDT701223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry