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General NPI Number Information
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NPI Number | 1356442511
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Entity Type | Individual
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Provider Name | JASON YAMAGUCHI DDS
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 555 COLLEGE DR SUITE A
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City | HENDERSON
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State | NV
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Zip | 89015-7575
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Country | US
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Telephone | 702-321-4022
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Fax | 702-304-1222
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Provider Business Mailing Address
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Address Line | 1723 FRANKLIN CHASE TER
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City | HENDERSON
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State | NV
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Zip | 89012-3474
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Country | US
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Telephone | 702-321-4022
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Fax | 702-304-1222
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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 | 4056
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License Number State | NV
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