MEDICARE: DR. NAOKO FUKUSHIMA DDS

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	122300000X	Dentist	019025718	IL
2	1223G0001X	General Practice Dentistry	DN23169	FL
3	1223G0001X	General Practice Dentistry	019025718	IL
4	122300000X	Dentist	DN23169	FL

General Provider Information

NPI Number	:	1780716803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAOKO FUKUSHIMA DDS

Provider Business Mailing Address
First Line	:	9258 SMITHIES ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-3841
Country	:	US
Telephone Number	:	773-230-1884
Fax Number	:

Provider Business Practice Location Address
First Line	:	2941 W ADDISON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-4635
Country	:	US
Telephone Number	:	773-230-1884
Fax Number	:

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	05/16/2025

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