Provider Demographics
NPI:1609072727
Name:JEFFREY Y YAMASHIRO DDS., INC.
Entity Type:Organization
Organization Name:JEFFREY Y YAMASHIRO DDS., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:YASUNORI
Authorized Official - Last Name:YAMASHIRO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-329-1312
Mailing Address - Street 1:1605 W REDONDO BEACH BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-3241
Mailing Address - Country:US
Mailing Address - Phone:310-329-1312
Mailing Address - Fax:310-329-1074
Practice Address - Street 1:1605 W REDONDO BEACH BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3241
Practice Address - Country:US
Practice Address - Phone:310-329-1312
Practice Address - Fax:310-329-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA037046122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty