Provider Demographics
NPI:1750270757
Name:ISHIKURA, SEIYA (DMD)
Entity type:Individual
Prefix:DR
First Name:SEIYA
Middle Name:
Last Name:ISHIKURA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 DRUMLIN HILL RD
Mailing Address - Street 2:
Mailing Address - City:BOLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01740-2023
Mailing Address - Country:US
Mailing Address - Phone:978-333-3118
Mailing Address - Fax:
Practice Address - Street 1:133 MARKET ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-6249
Practice Address - Country:US
Practice Address - Phone:978-458-1179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN10001030122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist