Provider Demographics
NPI:1174665947
Name:KAMAYATSU-PETERSON, ERIKA LYNNE (DDS)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:LYNNE
Last Name:KAMAYATSU-PETERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 MAIN ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1758
Mailing Address - Country:US
Mailing Address - Phone:650-369-3399
Mailing Address - Fax:650-369-3309
Practice Address - Street 1:369 MAIN ST
Practice Address - Street 2:SUITE 250
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1758
Practice Address - Country:US
Practice Address - Phone:650-369-3399
Practice Address - Fax:650-369-3309
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA283741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice