Provider Demographics
NPI:1811034598
Name:DAVE MAYEDA DDS INC
Entity Type:Organization
Organization Name:DAVE MAYEDA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MAYEDA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-636-7424
Mailing Address - Street 1:1142 N CHINOWTH
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4113
Mailing Address - Country:US
Mailing Address - Phone:559-636-7424
Mailing Address - Fax:559-636-7422
Practice Address - Street 1:1142 N CHINOWTH
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4113
Practice Address - Country:US
Practice Address - Phone:559-636-7424
Practice Address - Fax:559-636-7422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA287571223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty