Provider Demographics
NPI:1538630132
Name:YOSHIDA DENTAL, INC.
Entity type:Organization
Organization Name:YOSHIDA DENTAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:
Authorized Official - Last Name:YOSHIDA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-730-9900
Mailing Address - Street 1:137 W 1ST ST STE B-2
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3204
Mailing Address - Country:US
Mailing Address - Phone:714-730-9900
Mailing Address - Fax:
Practice Address - Street 1:137 W 1ST ST STE B-2
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3204
Practice Address - Country:US
Practice Address - Phone:714-730-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELMER YOSHIDA, DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-08
Last Update Date:2018-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental