Provider Demographics
NPI:1669493706
Name:ANTHONY R YAMADA, DDS, INC.
Entity Type:Organization
Organization Name:ANTHONY R YAMADA, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:RIKIO
Authorized Official - Last Name:YAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-546-2595
Mailing Address - Street 1:973 MANHATTAN BEACH BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5131
Mailing Address - Country:US
Mailing Address - Phone:310-546-2595
Mailing Address - Fax:310-545-7430
Practice Address - Street 1:973 MANHATTAN BEACH BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5131
Practice Address - Country:US
Practice Address - Phone:310-546-2595
Practice Address - Fax:310-545-7430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33414122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty