Provider Demographics
NPI:1902292923
Name:ANTHONY YAGOBI, D.D.S., INC.
Entity Type:Organization
Organization Name:ANTHONY YAGOBI, D.D.S., INC.
Other - Org Name:ORCHID DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:YAGOBI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-395-8888
Mailing Address - Street 1:320 LOS GATOS SARATOGA RD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-5318
Mailing Address - Country:US
Mailing Address - Phone:408-395-8888
Mailing Address - Fax:408-395-8885
Practice Address - Street 1:320 LOS GATOS SARATOGA RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-5318
Practice Address - Country:US
Practice Address - Phone:408-395-8888
Practice Address - Fax:408-395-8885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40709122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty