Provider Demographics
NPI:1477230514
Name:B. YAMASAKI, DDS, INC.
Entity Type:Organization
Organization Name:B. YAMASAKI, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:MELLENTHIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:365-099-6481
Mailing Address - Street 1:750 N CAPITOL AVE STE C7
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1942
Mailing Address - Country:US
Mailing Address - Phone:650-996-4813
Mailing Address - Fax:
Practice Address - Street 1:750 N CAPITOL AVE STE C7
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1942
Practice Address - Country:US
Practice Address - Phone:650-996-4813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty