Provider Demographics
NPI:1144436916
Name:FUJII, TINA M (DDS)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:FUJII
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 S CLOVERDALE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-4826
Mailing Address - Country:US
Mailing Address - Phone:206-762-2337
Mailing Address - Fax:
Practice Address - Street 1:1415 S CLOVERDALE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-4826
Practice Address - Country:US
Practice Address - Phone:206-762-2337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000085201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice