Provider Demographics
NPI:1194945030
Name:JAYE VENUTI, DDS AND MICHAEL YOKOYAMA, DDS, PROF. DENTAL CORP,
Entity type:Organization
Organization Name:JAYE VENUTI, DDS AND MICHAEL YOKOYAMA, DDS, PROF. DENTAL CORP,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:YOKOYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-815-8400
Mailing Address - Street 1:477 N EL CAMINO REAL
Mailing Address - Street 2:BLDG. C-306
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1328
Mailing Address - Country:US
Mailing Address - Phone:760-632-9055
Mailing Address - Fax:
Practice Address - Street 1:477 N EL CAMINO REAL
Practice Address - Street 2:BLDG. C-306
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-632-9055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA370611223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty