Provider Demographics
NPI:1588751978
Name:NISHIKAWA, NORMAN HITOSHI (DDS)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:HITOSHI
Last Name:NISHIKAWA
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 1:14655 BEL RED RD
Mailing Address - Street 2:F103
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3900
Mailing Address - Country:US
Mailing Address - Phone:425-641-1902
Mailing Address - Fax:
Practice Address - Street 1:14655 BEL RED RD
Practice Address - Street 2:F103
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3900
Practice Address - Country:US
Practice Address - Phone:425-641-1902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251030005746122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5005806Medicaid