Provider Demographics
NPI:1457860272
Name:NAKAMURA, HIROMI (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:HIROMI
Middle Name:
Last Name:NAKAMURA
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 FAITHON P LUCAS SR BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-1698
Mailing Address - Country:US
Mailing Address - Phone:469-322-8579
Mailing Address - Fax:
Practice Address - Street 1:1927 FAITHON P LUCAS SR BLVD STE 120
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-1698
Practice Address - Country:US
Practice Address - Phone:469-322-8579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38651122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist