Provider Demographics
NPI:1558780585
Name:BRANDON TOMI YAMAMURA DDS, MSD, PLLC
Entity Type:Organization
Organization Name:BRANDON TOMI YAMAMURA DDS, MSD, PLLC
Other - Org Name:KENT ENDODONTIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMAMURA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:425-765-2303
Mailing Address - Street 1:221 2ND AVE S STE 101
Mailing Address - Street 2:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60205619261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental