Provider Demographics
NPI:1871271676
Name:ISAGO, HIROSHI (DDS)
Entity type:Individual
Prefix:
First Name:HIROSHI
Middle Name:
Last Name:ISAGO
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 1:13623 SPRING POINT VW
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-6541
Mailing Address - Country:US
Mailing Address - Phone:832-877-3971
Mailing Address - Fax:
Practice Address - Street 1:909 W MONTGOMERY ST # 400
Practice Address - Street 2:
Practice Address - City:WILLIS
Practice Address - State:TX
Practice Address - Zip Code:77378-8653
Practice Address - Country:US
Practice Address - Phone:936-506-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39525122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist