Provider Demographics
NPI:1386640472
Name:YAMADA, ANTHONY RIKIO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:RIKIO
Last Name:YAMADA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:973 MANHATTAN BEACH BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5131
Mailing Address - Country:US
Mailing Address - Phone:310-546-2595
Mailing Address - Fax:310-545-7430
Practice Address - Street 1:973 MANHATTAN BEACH BLVD
Practice Address - Street 2:STE D
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5131
Practice Address - Country:US
Practice Address - Phone:310-546-2595
Practice Address - Fax:310-545-7430
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33414122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist