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General NPI Number Information
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NPI Number | 1609072727
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Entity Type | Organization
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Legal Business Name | JEFFREY Y YAMASHIRO DDS., INC.
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1605 W REDONDO BEACH BLVD SUITE 203
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City | GARDENA
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State | CA
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Zip | 90247-3241
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Country | US
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Telephone | 310-329-1312
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Fax | 310-329-1074
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Provider Business Mailing Address
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Address Line | 1605 W REDONDO BEACH BLVD SUITE 203
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City | GARDENA
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State | CA
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Zip | 90247-3241
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Country | US
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Telephone | 310-329-1312
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Fax | 310-329-1074
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY YASUNORI YAMASHIRO
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Credential | DDS
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Telephone | 310-329-1312
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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 | 037046
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License Number State | CA
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