Provider Demographics
NPI:1750508750
Name:YEMOTO, WESLEY PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:PAUL
Last Name:YEMOTO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4860 CHERRY AVE STE F
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-3716
Mailing Address - Country:US
Mailing Address - Phone:408-266-9957
Mailing Address - Fax:408-266-1407
Practice Address - Street 1:4860 CHERRY AVE STE F
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-3716
Practice Address - Country:US
Practice Address - Phone:408-266-9957
Practice Address - Fax:408-266-1407
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA270921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice