Provider Demographics
NPI:1083888499
Name:MICHELE YAMADA,DDS, INC
Entity Type:Organization
Organization Name:MICHELE YAMADA,DDS, INC
Other - Org Name:OCEAN DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-223-3423
Mailing Address - Street 1:1802 CABLE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-3103
Mailing Address - Country:US
Mailing Address - Phone:619-223-3423
Mailing Address - Fax:619-223-2950
Practice Address - Street 1:1802 CABLE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-3103
Practice Address - Country:US
Practice Address - Phone:619-223-3423
Practice Address - Fax:619-223-2950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37613122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty