Provider Demographics
NPI:1306539630
Name:CHESTER YOKOYAMA DDS, DENTAL OFFICE, INC.
Entity type:Organization
Organization Name:CHESTER YOKOYAMA DDS, DENTAL OFFICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-484-2625
Mailing Address - Street 1:1127 WILSHIRE BLVD STE 908
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3910
Mailing Address - Country:US
Mailing Address - Phone:213-484-2625
Mailing Address - Fax:213-484-6277
Practice Address - Street 1:1127 WILSHIRE BLVD STE 908
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3910
Practice Address - Country:US
Practice Address - Phone:213-484-2625
Practice Address - Fax:213-484-6277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty