Provider Demographics
NPI:1467741322
Name:YAMAMURA, BRANDON TOMI (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:TOMI
Last Name:YAMAMURA
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 2ND AVE S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-5873
Mailing Address - Country:US
Mailing Address - Phone:253-854-2057
Mailing Address - Fax:
Practice Address - Street 1:221 2ND AVE S STE 101
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5873
Practice Address - Country:US
Practice Address - Phone:253-854-2057
Practice Address - Fax:253-854-2070
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE602056191223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics