Provider Demographics
NPI:1245902873
Name:UYEHARA, AMANDA (DDS)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:UYEHARA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10111 SCENIC BLVD
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2724
Mailing Address - Country:US
Mailing Address - Phone:408-813-6924
Mailing Address - Fax:
Practice Address - Street 1:100 OCONNOR DR STE 5
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1638
Practice Address - Country:US
Practice Address - Phone:408-813-6924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1070291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice