Healthcare Provider Details

I. General information

NPI: 1124818208
Provider Name (Legal Business Name): KATRINA NAOKO NISHIKAWA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN STREET
CINCINNATI OH
45219-0796
US

IV. Provider business mailing address

200 ALBERT SABIN WAY
CINCINNATI OH
45267-2800
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-2586
  • Fax: 513-584-1125
Mailing address:
  • Phone: 513-584-2586
  • Fax: 513-584-1125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: