Provider Demographics
NPI:1588060420
Name:SHIMIZU, YOSHIHITO (DDS)
Entity type:Individual
Prefix:
First Name:YOSHIHITO
Middle Name:
Last Name:SHIMIZU
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 1:100 GALLERIA PKWY SE
Mailing Address - Street 2:SUITE6 670
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3179
Mailing Address - Country:US
Mailing Address - Phone:770-272-1818
Mailing Address - Fax:770-272-1817
Practice Address - Street 1:100 GALLERIA PKWY SE
Practice Address - Street 2:SUITE6 670
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3179
Practice Address - Country:US
Practice Address - Phone:770-272-1818
Practice Address - Fax:770-272-1817
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013638122300000X
OH30.023870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist