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General NPI Number Information
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NPI Number | 1114940921
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Entity Type | Individual
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Provider Name | BRUCE TAKASHI HIURA DDS
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 2305 VAN NESS AVE STE E
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-1899
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Country | US
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Telephone | 415-776-5855
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Fax | 415-776-4656
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Provider Business Mailing Address
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Address Line | 2305 VAN NESS AVE STE E
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-1899
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Country | US
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Telephone | 415-776-5855
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Fax | 415-776-4656
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30826
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 30826
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License Number State | CA
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