Provider Demographics
NPI:1487988895
Name:HIURA, KENT T (DDS)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:T
Last Name:HIURA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 N 1ST ST
Mailing Address - Street 2:STE B
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5326
Mailing Address - Country:US
Mailing Address - Phone:408-279-2992
Mailing Address - Fax:408-279-0203
Practice Address - Street 1:595 N 1ST ST
Practice Address - Street 2:STE B
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5326
Practice Address - Country:US
Practice Address - Phone:408-279-2992
Practice Address - Fax:408-279-0203
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADF0334691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice