Individual ProviderDouglas Kiyoshi NakamotoDentistDental ProvidersPractice Address333 Gellert Blvd, Suite#125, Daly City, CA 94015-2621(650) 992-1500(650) 596-6558PECOS EnrollmentBased on the most recent information from CMS, provider Douglas Kiyoshi Nakamoto does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1548488430Provider TypeIndividualFull NameNakamoto, Douglas KiyoshiTitleDr.CredentialD.D.S.GenderMaleSole ProprietorYesEnumeration Date4/23/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address333 Gellert Blvd, Suite#125, Daly City, CA 94015-2621Phone(650) 992-1500Fax(650) 992-1520Mailing LocationMailing Address1332 Geneva Ave, San Carlos, CA 94070-4821Phone(650) 596-6558FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense34637California