Provider Demographics
NPI:1467627273
Name:ROBERT Y. TAKANO, DDS, INC
Entity Type:Organization
Organization Name:ROBERT Y. TAKANO, DDS, INC
Other - Org Name:LA JOLLA HEATH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-342-8914
Mailing Address - Street 1:PO BOX 1333
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-7333
Mailing Address - Country:US
Mailing Address - Phone:858-342-8914
Mailing Address - Fax:
Practice Address - Street 1:13340 BARBADOS WAY
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-3502
Practice Address - Country:US
Practice Address - Phone:858-342-8914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA525011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty