Basic Information
Provider Information
NPI: 1831508365
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ONO
FirstName: NORIAKI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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OtherLastName:  
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Mailing Information
Address1: 1011 N UNIVERSITY AVE
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481091078
CountryCode: US
TelephoneNumber: 7347641522
FaxNumber: 7347638100
Practice Location
Address1: 1011 N UNIVERSITY AVE
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481091078
CountryCode: US
TelephoneNumber: 7347641522
FaxNumber: 7347638100
Other Information
ProviderEnumerationDate: 08/08/2014
LastUpdateDate: 08/08/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223X0400X2901021306MIY Dental ProvidersDentistOrthodontics and Dentofacial Orthopedics

No ID Information.


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