Provider Demographics
NPI:1730193749
Name:SAKASEGAWA, ALAN YOSHIO (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:YOSHIO
Last Name:SAKASEGAWA
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:2400 BALFOUR RD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-4945
Mailing Address - Country:US
Mailing Address - Phone:925-634-9794
Mailing Address - Fax:925-634-9796
Practice Address - Street 1:2400 BALFOUR RD
Practice Address - Street 2:SUITE 315
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-4945
Practice Address - Country:US
Practice Address - Phone:925-634-9794
Practice Address - Fax:925-634-9796
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA420891223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics