Provider Demographics
NPI:1033276928
Name:NAKAYAMA, YOSHINARI (DDS)
Entity Type:Individual
Prefix:DR
First Name:YOSHINARI
Middle Name:
Last Name:NAKAYAMA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:YOSHINARI
Other - Middle Name:
Other - Last Name:NAKAYAMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:5007 NORPOINT WAY NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-4272
Mailing Address - Country:US
Mailing Address - Phone:253-952-0169
Mailing Address - Fax:
Practice Address - Street 1:2505 S 320TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5400
Practice Address - Country:US
Practice Address - Phone:206-400-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000054611223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics