MEDICARE: DOUGLAS TSUYOSHI SAKURAI D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	36279	CA

General Provider Information

NPI Number	:	1396735866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS TSUYOSHI SAKURAI D.D.S.

Provider Business Mailing Address
First Line	:	801 N TUSTIN AVE
Second Line	:	STE 301
City	:	SANTA ANA
State	:	CA
Zip	:	92705-3612
Country	:	US
Telephone Number	:	714-547-5437
Fax Number	:	714-547-9947

Provider Business Practice Location Address
First Line	:	801 N TUSTIN AVE
Second Line	:	STE 301
City	:	SANTA ANA
State	:	CA
Zip	:	92705-3612
Country	:	US
Telephone Number	:	714-547-5437
Fax Number	:	714-547-9947

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	07/08/2007

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