MEDICARE: DR. STANLEY T UYEYAMA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	19812	CA

General Provider Information

NPI Number	:	1881897643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY T UYEYAMA DDS

Provider Business Mailing Address
First Line	:	1060 N VENTURA RD
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93030-3855
Country	:	US
Telephone Number	:	805-983-0588
Fax Number	:	805-983-6606

Provider Business Practice Location Address
First Line	:	1060 N VENTURA RD
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93030-3855
Country	:	US
Telephone Number	:	805-983-0588
Fax Number	:	805-983-6606

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	07/08/2007

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