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General NPI Number Information
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NPI Number | 1144581703
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Entity Type | Individual
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Provider Name | BETH YAMASHIRO D.D.S, M.B.A
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Gender | Female
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 9480 S EASTERN AVE STE 145
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City | LAS VEGAS
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State | NV
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Zip | 89123-8028
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Country | US
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Telephone | 702-706-2468
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Fax | 866-770-2875
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Provider Business Mailing Address
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Address Line | 9480 S EASTERN AVE STE 145
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City | LAS VEGAS
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State | NV
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Zip | 89123-8028
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 61134
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5982
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | S3-238
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License Number State | NV
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