Provider Demographics
NPI:1144581703
Name:YAMASHIRO, BETH (DDS, MBA)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:
Last Name:YAMASHIRO
Suffix:
Gender:F
Credentials:DDS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9480 S EASTERN AVE STE 145
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-8028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9480 S EASTERN AVE STE 145
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-8028
Practice Address - Country:US
Practice Address - Phone:702-706-2468
Practice Address - Fax:866-770-2875
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61134122300000X
NV5982122300000X
NVS3-2381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist