Provider Demographics
NPI:1902116445
Name:ROGER M. YAMASHIRO, DDS, APC
Entity Type:Organization
Organization Name:ROGER M. YAMASHIRO, DDS, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:MASASHI
Authorized Official - Last Name:YAMASHIRO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-782-6877
Mailing Address - Street 1:1261 CABRILLO AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-2868
Mailing Address - Country:US
Mailing Address - Phone:310-782-6877
Mailing Address - Fax:
Practice Address - Street 1:1261 CABRILLO AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-2868
Practice Address - Country:US
Practice Address - Phone:310-782-6877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty