Provider Demographics
NPI:1548527211
Name:AMEMIYA, ALAN GEORGE (DDS)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:GEORGE
Last Name:AMEMIYA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 HILBY AVE
Mailing Address - Street 2:STE #27
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955
Mailing Address - Country:US
Mailing Address - Phone:831-394-5265
Mailing Address - Fax:831-394-8554
Practice Address - Street 1:915 HILBY AVE
Practice Address - Street 2:STE #27
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955
Practice Address - Country:US
Practice Address - Phone:831-394-5265
Practice Address - Fax:831-394-8554
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42260122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist