Healthcare Provider Details

I. General information

NPI: 1366462673
Provider Name (Legal Business Name): ROBERT K. HIGA, DDS, MS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4959 ARLINGTON AVE SUITE L
RIVERSIDE CA
92504-2756
US

IV. Provider business mailing address

4959 ARLINGTON AVE SUITE L
RIVERSIDE CA
92504-2756
US

V. Phone/Fax

Practice location:
  • Phone: 951-343-0696
  • Fax: 951-343-0697
Mailing address:
  • Phone: 951-343-0696
  • Fax: 951-343-0697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number35901
License Number StateCA

VIII. Authorized Official

Name: DR. ROBERT KENJIRO HIGA
Title or Position: PRESIDENT
Credential:
Phone: 951-343-0696