# KYLE NISHIMURA, DMD, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Orange Grove Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134666951
- **Authorized official:** KYLE NISHIMURA DMD (DENTIST)
- **Authorized official phone:** (310) 525-6996

## Contact information

- **Practice address:** 1467 N WANDA RD STE 105, VILLA PARK, CA 92867-5344
- **Practice address phone:** (310) 525-6996
- **Mailing address:** 16610 TAYLOR CT, TORRANCE, CA 90504-2237
- **Mailing address phone:** (310) 525-6996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 62496 | CA | Yes |

## Other

- **Enumeration date:** 01/31/2017
- **Last updated:** 01/31/2017