Healthcare Provider Details

I. General information

NPI: 1093985905
Provider Name (Legal Business Name): HIROMI KOBAYASHI D.D.S.,M.S.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19280 STEVENS CREEK BLVD
CUPERTINO CA
95014-2504
US

IV. Provider business mailing address

19280 STEVENS CREEK BLVD
CUPERTINO CA
95014-2504
US

V. Phone/Fax

Practice location:
  • Phone: 408-253-3180
  • Fax: 408-253-3182
Mailing address:
  • Phone: 408-253-3180
  • Fax: 408-253-3182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number46844
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: