MEDICARE: DR. JOSHUA K. NAGAO D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	D009249	AZ

General Provider Information

NPI Number	:	1407236151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA K. NAGAO D.D.S.

Provider Business Mailing Address
First Line	:	3922 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-3276
Country	:	US
Telephone Number	:	801-660-0048
Fax Number	:

Provider Business Practice Location Address
First Line	:	3922 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-3276
Country	:	US
Telephone Number	:	801-660-0048
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2015
Last Update Date	:	06/08/2015

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