Healthcare Provider Details

I. General information

NPI: 1598593675
Provider Name (Legal Business Name): ALBERTO NORIYUKI KOJIMA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7932 W SAND LAKE RD
ORLANDO FL
32819-7263
US

IV. Provider business mailing address

17820 SHARP PUMMELO ALY
WINTER GARDEN FL
34787-6817
US

V. Phone/Fax

Practice location:
  • Phone: 407-544-0777
  • Fax:
Mailing address:
  • Phone: 585-267-9452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number29290
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: