Provider Demographics
NPI:1437209970
Name:YANASE, ROY TAKASHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:TAKASHI
Last Name:YANASE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22330 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 316
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-2536
Mailing Address - Country:US
Mailing Address - Phone:310-378-4244
Mailing Address - Fax:310-378-0164
Practice Address - Street 1:22330 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 316
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2590
Practice Address - Country:US
Practice Address - Phone:310-378-4244
Practice Address - Fax:310-378-0164
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA206061223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics